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Updated 30 June 2021

What is Pancreatitis? – Symptoms, Diagnosis, and Treatment

Patient with upper abdominal pain symptoms resulting from kidney stones

What is Pancreatitis?

Pancreatitis is a condition where the pancreas has become inflamed. This disrupts the pancreas's function for digestion and controlling blood sugar levels which are vital for survival. When healthy, the pancreas is an essential gland for producing digestive juices and hormones, such as insulin and glucagon.  More information about its symptoms, diagnosis, and treatment will be outlined in the rest of the article.   

Pancreas Location

The pancreas is an organ that sits behind the stomach. It is also located near other structures, such as the spleen and common bile duct. From an outsider's perspective, pancreas pain is located along the upper abdominal region. 
 

Types of Pancreatitis

There are two main types of pancreatitis which are either "acute" or "chronic."  Acute pancreatitis occurs quickly and can often last for days before recovering. However, it can become very infected and severe. Between 10-30% of these severe cases can even result in death On the other hand, chronic pancreatitis occurs slowly over time and can persist for weeks, months, or even years. If the pancreas becomes constantly inflamed or does not heal, permanent damage can occur. As acute and chronic pancreatitis affect people differently, they require individualised management. Seeking the assistance of qualified medical professionals is crucial for early diagnosis and treatment to ensure optimal recovery. 
 

Pancreatitis Symptoms

Understanding these symptoms is vital for determining a correct diagnosis. If you feel that you are experiencing these pancreatitis symptoms, please inform your doctor. 

Acute Pancreatitis Symptoms 

Symptoms of acute pancreatitis often have a sudden onset [2]. Most episodes of acute pancreatitis are mild, which can sometimes resolve without treatment. However, around 15% of cases are considered severe, which can be fatal.
  • Sudden onset of upper abdominal pain which can refer to the back
  • Upper abdominal pain, which eases with bent positions (e.g., sitting, tying shoelaces, etc.)
  • Nausea
  • Vomiting 
  • Fever
  • Sweating

Chronic Pancreatitis Symptoms 

While chronic pancreatitis worsens gradually over time, many will notice that their chronic pancreatitis will have current symptoms [5]
  • Upper abdominal pain, which can also refer to the back
  • Upper abdominal pain, which eases with bent positions (e.g., sitting, tying shoelaces, etc.)
  • Nausea
  • Vomiting 
  • Fatty and smelly stool
  • Gradual weight loss
 

Complications of Pancreatitis 

Acute Pancreatitis 

Early treatment and hospitalisation of acute pancreatitis help reduce the likely complications. In milder stages of this condition, imaging analysis may not be needed and maybe discharged from hospital in as early as 3-5 days [2]. Those with more severe pancreatitis may have serious complications, such as infection and organ failure. In these situations, appropriate medical treatment will be immediately required as conditions can quickly become fatal.   

Chronic Pancreatitis

Recurring or chronic pancreatitis can lead to permanent complications and disability [4, 5]. Over years, many people with this condition will most commonly develop abdominal pain, diabetes, and digestive problems. Other complications associated with chronic pancreatitis can include:
  • Osteoporosis or osteopenia
  • Weight loss
  • Pancreatic cysts
  • Pseudocysts
  • Pancreatic cancer
  • Bowel obstruction
 

Pancreatitis Causes

Identifying the causes of this condition is crucial to ensure proper management of the condition. However, this can be complicated as acute and chronic pancreatitis can be caused by various factors. Prompt consultation with a medical doctor will ensure that the cause is detected as early as possible. 

Acute Pancreatitis Causes

The two most common causes of acute pancreatitis are long-term alcohol consumption and gallbladder disease [1]. However, there are also potentially other potential risk factors that can cause this condition, including:
  • Infections
  • Autoimmune disease
  • Drug abuse
  • Tumours
  • Surgery
  • Hypercalcaemia (excess calcium in bloodstream)
 

Chronic Pancreatitis Causes 

Many people with chronic pancreatitis will initially not experience the classic chronic pancreatitis symptoms. Most will face recurring episodes of acute pancreatitis, which eventually becomes chronic over the years or even decades [4]. Whilst there are various causes for chronic pancreatitis, unhealthy habits, including alcohol consumption and smoking, can repeatedly cause inflammation in the pancreas.  Examples of the leading causes of chronic pancreatitis include:
  • Alcohol consumption
  • Smoking
  • Compromised immune system
  • Genetics 
  • Bile duct obstruction or blockage to the pancreas
  • Idiopathic or unknown reasons 
 

Pancreatitis Diagnosis and Tests

Acute Pancreatitis

If acute pancreatitis is suspected, immediate attention and hospitalisation may be required within the first 12-24 hours [2]. This is to ensure that appropriate tests and monitoring are carried out. Medical doctors will assess the patient's symptoms, conduct blood tests and imaging for a proper diagnosis.  Blood tests will assess for amylase or lipase levels in the blood, which are digestive pancreatic enzymes. Additionally, imaging investigations, such as computed tomography (CT), magnetic resonance imaging (MRI), or ultrasound, may also need to be conducted. In some instances, endoscopic retrograde cholangiopancreatography (ECRP) investigations may also be considered to look out for related gallstones [2]  

Chronic Pancreatitis  

Chronic pancreatitis can present differently depending on which stage the condition has progressed. As there is no single test for the chronic variant of this condition, doctors may use a range of tests to make a more accurate diagnosis. Examples of commonly prescribed tests can include:
  • Comprehensive blood tests
  • Pancreatic functional tests 
  • CT scans
  • Ultrasound
  • Endoscopic retrograde cholangiopancreatography (ECRP)
  • MRI
  • X-rays
  • Biopsies
Depending on the clinical need, costs, and availability of these tests, your doctor may need to conduct only a few or multiple assessments. 
 

Pancreatitis Treatment

How to treat pancreatitis will depend on the type and severity of the condition. A multidisciplinary approach with doctors, gastroenterologists, surgeons, nutritionists, dietitians, and/or other specialists will be necessary.  

Acute Pancreatitis Treatment 

Those with acute pancreatitis need immediate medical attention and hospitalisation to minimise the risk of serious complications [2]
  • Fluid resuscitation or therapy through an intravenous drip for rehydration
  • Medicine for pain management, infections and other potential complications
  • Nutritional support to reduce complications and pain. Your nutritionist or dietitian may recommend changes to your meal plan. However, some will not be allowed to eat in the early stages and require a feeding tube.
  • Intensive care support, such as endoscopy, interventional radiology and surgery, may be required in those who do not respond to previous treatment and/or experiencing more severe complications.

Chronic Pancreatitis Treatment 

Treatments of chronic pancreatitis aim to improve quality of life, pain management, reducing disability, and decreasing the risk of mortality [5]
  • Avoid alcohol consumption
  • Stop smoking
  • Medication
  • Dietary changes may involve consuming smaller, frequent and low-fat meals.
  • Endoscopic treatments for removing gallstones, pseudocysts and pancreas strictures
  • Surgery will often be considered in around half of the people with this condition, especially those with uncontrolled pain, obstructions and suspected cancer. 
 

Recovery - How Long Does Pancreatitis Take to Heal? 

Recovery from pancreatitis will often depend on a combination of factors, including the severity of the condition, lifestyle choices and genetics.   

Acute Pancreatitis

Many of those with mild acute pancreatitis will be shortly discharged after hospitalisation and recover within a week. However, those with more severe complications, such as organ failure and infection, may require extended hospitalisation and further treatment. Unfortunately, this condition can become fatal. Up to 25% of those with previous episodes of acute pancreatitis will have repeated episodes in the future. However, this can be reduced by adhering to healthier lifestyles, such as exercise, dietary changes, avoiding alcohol and quitting smoking.   

Chronic Pancreatitis 

Those with chronic pancreatitis will experience permanent and progressive damage to the pancreas. Significantly, changes to lifestyle (i.e., diet, smoking, alcohol consumption, etc.) and receiving the correct medical treatment can help manage symptoms and slow down the disease progression. Individuals diagnosed with this condition will also be at a significantly higher risk of developing pancreatic cancer and will need to be monitored regularly. 
   

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References

  1. Carroll, J., Herrick, B., Gipson, T., & Lee, S. (2007). Acute pancreatitis: diagnosis, prognosis and treatment. American family physician Volume 75, Number 10◆ May 15, 2007.
  2. Wu, B. U., & Banks, P. A. (2013). Clinical management of patients with acute pancreatitis. Gastroenterology, 144(6), 1272-1281.
  3. Pancreas Foundation (2001). Retrieved from: https://pancreasfoundation.org/patient-information/acute-pancreatitis/acute-pancreatitis-risks-and-treatment/ 
  4. Majumder, S., & Chari, S. T. (2016). Chronic pancreatitis. The Lancet, 387(10031), 1957-1966. 
  5. Barry, K. (2018). Chronic pancreatitis: diagnosis and treatment. American family physician, 97(6), 385-393.