Pancreatitis

Pancreatitis Treatment

Pancreatitis is a fairly uncommon condition that involves the inflammation of the pancreas. It’s estimated that pancreatitis only affects 5 to 35 people per 100,000 worldwide; however, these numbers are rising due to obesity, which is a contributing factor to gallstones. Pancreatitis is most often caused by gallstones or heavy alcohol usage and can be either acute or chronic. Cases of pancreatitis require formal treatment, especially as the condition could be life-threatening if not treated. Read on to learn more about the different types of pancreatitis, the causes of the condition, and when you should seek medical attention for pancreatitis treatment.

What Is Pancreatitis?

The pancreas is located in the upper abdomen and connects to the duodenum (the top part of the small intestine). It has two main functions. First, the pancreas makes digestive enzymes to send to the small intestine through the pancreatic ducts. This helps break down protein, carbohydrates, and fats. Secondly, the pancreas releases hormones into the blood, namely insulin and glucagon, to regulate sugar levels in the blood.

Pancreatitis occurs when the pancreas becomes inflamed and swells. This occurs when the digestive enzymes in the pancreas are released and activated prematurely in the pancreatic tissue. The enzymes will then damage and inflame the tissue. An inflamed pancreas can lead to the release of toxins and inflammatory markers, which can lead to damage to your other organs. A patient who suspects they have pancreatitis should consult their GI doctor as soon as possible.

Types of Pancreatitis

There are two types of pancreatitis, and it can be either acute or chronic.

Acute pancreatitis has a sudden onset and is a short-term condition. It usually requires a hospital stay to both diagnose and treat it. Most patients with acute pancreatitis do respond to treatment and get better within a few days.

Chronic pancreatitis is a long-term condition where the pancreas gets repeatedly inflamed and damaged over time. These cases require treatment such as medications or surgery to manage it.

What Are the Symptoms of Pancreatitis?

The symptoms of pancreatitis may depend on whether it is acute or chronic, but some of the symptoms are shared. The most common symptom of pancreatitis is upper abdominal pain. Signs and symptoms of acute pancreatitis include:

• Abdominal pain that can radiate to the back
• Rapid pulse
• Nausea
• Vomiting
• Fever
• Tenderness in the abdomen 

Common symptoms of chronic pancreatitis include:

• Unintended weight loss
• Abdominal pain that is worsened by eating
• Smelly or oily stool

If your onset of symptoms is sudden or you have abdominal pain that persists, you should consult your gastroenterologist for diagnosis and pancreatitis treatment.

What Causes Pancreatitis?

The two main causes of pancreatitis are gallstones (hard, stone-like pieces that form in the gallbladder from high cholesterol or high bilirubin) and heavy alcohol usage. There are other less common causes of pancreatitis, however. These include:

• High fat (triglyceride) levels in the blood
• Infection
• Medications that irritate the pancreas, such as 
• Genetic disorders, such as cystic fibrosis 
• Metabolic disorders, such as diabetes
• Abdominal injury

Certain risk factors can also predispose you to pancreatitis. These include:

• Drinking alcohol heavily (more than three drinks per day)
• Having a high-fat diet 
• Having high levels of calcium in the blood
• Being obese
• Having a family history of  pancreatitis
• Diabetes
• Chronic kidney disease
• Smoking cigarettes

While you can’t control some of these risk factors, you can reduce your risk of developing pancreatitis by limiting alcohol intake, quitting smoking, and adhering to a low-fat diet.

When to Get Medical Treatment for Pancreatitis

For pancreatitis treatment, you’ll need a diagnosis. You should seek pancreatitis treatment if you have persistent abdominal pain or have a sudden onset of what may feel like acute pancreatitis. For acute pancreatitis, your doctor will likely order blood tests to measure the levels of digestive enzymes in the pancreas. Also, you may get a CT (computed tomography) scan or ultrasound to look for abnormalities in the pancreas, gallbladder, and bile ducts.

Diagnosing chronic pancreatitis requires more testing and is more involved. Diagnostic tests for chronic pancreatitis include:

• Secretin pancreatic function test. This tests the body’s response to the hormone secretin.
• ERCP (endoscopic retrograde cholangiopancreatography). This is an endoscopic procedure, where a thin tube is inserted into your mouth, down through the stomach, and to the ampulla (where the pancreas and bile duct open). If gallstones or pancreas stones are present during this procedure, they can be removed.
• Stool test. This tests to see how well your body breaks down fat.
• Endoscopic ultrasound (EUS). This is an endoscopic procedure that uses ultrasound to see your pancreas and pancreatic ducts.

Pancreatitis treatment also depends on whether the condition is acute or chronic. According to the National Institutes of Health, pancreatitis complications can lead to:

• Blockage in the bile duct
• Blockage in the pancreatic ducts
• Pancreas damage
• Development of pancreatic cysts or pseudocysts
• Damage to the heart, lungs, or kidneys 
• Death

An acute case of pancreatitis will likely require a short hospital stay for monitoring and care. If your pancreas isn’t functioning properly, you may be given supplemental pancreatic enzymes and insulin. Pain medication is often given to help keep the patient comfortable during their hospital stay. In some cases, your physician may perform an endoscopic or surgical procedure to remove a damaged part of the pancreas, gallstones, or blockage.

In more severe and chronic cases, sometimes surgery is advised. Modern medicine allows surgeons to use laparoscopic procedures, which are much less invasive than typical surgery. During laparoscopic surgery, a small incision is made and a laparoscope (instrument with light and a tiny camera) helps guide the procedure. Gallbladder surgery or pancreatic procedures may be necessary, depending on the inflammation.

ERCP can also be used to remove bile duct obstructions.

Treatment for alcohol dependence or alcohol use disorder (AUD) may also be used in conjunction with pancreatitis treatment if the cause of the pancreatitis was prolonged, heavy drinking.