Episodes last from two days to two weeks. Other causes of chronic pancreatitis are congenital conditions such as pancreas divisum, cystic fibrosis, high levels of calcium in the blood hypercalcemia , high levels of blood fats hyperlipidemia or hypertriglyceridemia , some drugs, and certain autoimmune conditions.
Most people with chronic pancreatitis have abdominal pain, although some people have no pain at all. The pain may get worse when eating or drinking, spread to the back, or become constant and disabling. In certain cases, abdominal pain goes away as the condition advances, probably because the pancreas is no longer making digestive enzymes.
Other symptoms include nausea, vomiting, weight loss, and fatty stools. People with chronic disease often lose weight, even when their appetite and eating habits are normal. The weight loss occurs because the body does not secrete enough pancreatic enzymes to break down food, so nutrients are not absorbed normally. Poor digestion leads to excretion of fat, protein, and sugar into the stool. If the insulin-producing cells of the pancreas islet cells have been damaged, diabetes may also develop at this stage.
Diagnosis may be difficult, but new techniques can help. Pancreatic function tests help a doctor decide whether the pancreas is still making enough digestive enzymes. Using ultrasonic imaging, endoscopic retrograde cholangiopancreatography ERCP , and CT scans, a doctor can see problems indicating chronic pancreatitis. Such problems include calcification of the pancreas, in which tissue hardens from deposits of insoluble calcium salts. In more advanced stages of the disease, when diabetes and malabsorption occur, a doctor can use a number of blood, urine, and stool tests to help diagnose chronic pancreatitis and to monitor its progression.
Relieving pain is the first step in treating chronic pancreatitis. The next step is to plan a diet that is high in carbohydrates and low in fat. A doctor may prescribe pancreatic enzymes to take with meals if the pancreas does not secrete enough of its own. The enzymes should be taken with every meal to help the body digest food and regain some weight. Sometimes insulin or other drugs are needed to control blood glucose. In some cases, surgery is needed to relieve pain.
The surgery may involve draining an enlarged pancreatic duct or removing part of the pancreas. For fewer and milder attacks, people with pancreatitis must stop drinking alcohol, stick to their prescribed diet, and take the proper medications. American Gastroenterological Association. Phone: Normally, digestive enzymes do not become active until they reach the small intestine, where they begin digesting food.
Acute Pancreatitis Some people have more than one attack and recover completely after each, but acute pancreatitis can be a severe, life-threatening illness with many complications. Symptoms Acute pancreatitis usually begins with pain in the upper abdomen that may last for a few days.
Other symptoms may include: swollen and tender abdomen nausea vomiting fever rapid pulse Severe cases may cause dehydration and low blood pressure. Treatment Treatment depends on the severity of the attack. Complications Acute pancreatitis can cause breathing problems. Gallstones and Pancreatitis Gallstones can cause pancreatitis and they usually require surgical removal. The main causes of chronic pancreatitis are: alcoholism blocked or narrowed pancreatic duct because of trauma or pseudocysts have formed heredity unknown cause idiopathic Damage from alcohol abuse may not appear for many years, and then a person may have a sudden attack of pancreatitis.
Some cases of chronic pancreatitis are idiopathic, meaning that the cause is unknown. Symptoms Most people with chronic pancreatitis have abdominal pain, although some people have no pain at all.
Diagnosis Diagnosis may be difficult, but new techniques can help. Treatment Relieving pain is the first step in treating chronic pancreatitis.
Pancreatitis has two forms: acute and chronic. Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Egton Medical Information Systems Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
In this series. In this article Symptoms of acute pancreatitis What happens if acute pancreatitis is suspected? When should I call a doctor?
What is the pancreas? What is pancreatitis? Causes of acute pancreatitis What happens in acute pancreatitis?
Acute pancreatitis treatment What is the outlook prognosis for acute pancreatitis? Will it happen again? Acute Pancreatitis In this article Symptoms of acute pancreatitis What happens if acute pancreatitis is suspected? Symptoms of acute pancreatitis Tummy abdominal pain, just below the ribs, is the usual main symptom. It usually builds up quickly over a few hours and may last for several days. The pain can become severe and is typically felt spreading through to the back. The pain may be sudden and intense, or it may begin as a mild pain that is aggravated by eating and slowly grows worse.
However, it is occasionally possible to have acute pancreatitis without any pain. This is more common if you have diabetes or have kidney problems. Being sick vomiting , a high temperature fever and generally feeling very unwell are common. Your abdomen may become swollen.
If the pancreatitis becomes severe and other organs become involved for example, your heart, lungs or kidneys then various other symptoms may develop. You may become lacking in fluid in the body dehydrated and have low blood pressure. Acute pancreatitis can cause you to be very poorly and can even be life-threatening.
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Can you get gallstones when you're young? Gallstones diet sheet. What does the pancreas do? Want to see a dietician? Book a private assessment with a qualified dietician today. Book now. Many drugs can irritate the pancreas. Usually, the inflammation resolves when the drugs are stopped. Drugs such as angiotensin-converting enzyme ACE inhibitors, azathioprine , furosemide , 6- mercaptopurine , pentamidine , sulfa drugs, and valproate.
Estrogen use in women with high levels of lipids in the blood. High levels of calcium in the blood Hypercalcemia High Level of Calcium in the Blood In hypercalcemia, the level of calcium in blood is too high. A high calcium level may result from a problem with the parathyroid glands, as well as from diet, cancer, or disorders affecting Viruses such as mumps Mumps Mumps is a contagious viral infection that causes painful enlargement of the salivary glands.
The infection may also affect the testes, brain, and pancreas, especially in adults. Mumps is caused Enterovirus infections are caused by many different viruses. Hepatitis A is usually spread when people ingest something that has Hepatitis E is usually spread when people ingest something that has been contaminated by the stool of an infected person High levels of triglycerides in the blood hypertriglyceridemia Dyslipidemia Dyslipidemia is a high level of lipids cholesterol, triglycerides, or both or a low high-density lipoprotein HDL cholesterol level.
Lifestyle, genetics, disorders such as low thyroid hormone Damage to the pancreas caused by surgery or endoscopy such as endoscopic retrograde cholangiopancreatography Endoscopic Retrograde Cholangiopancreatography Imaging tests of the liver, gallbladder, and biliary tract include ultrasonography, radionuclide scanning, computed tomography CT , magnetic resonance imaging MRI , endoscopic retrograde cholangiopancreatography Cancer of the pancreas Pancreatic Cancer Smoking, chronic pancreatitis, male sex, being black, and possibly long-standing diabetes are risk factors for pancreatic cancer.
Abdominal pain, weight loss, jaundice, and vomiting are some Hereditary pancreatitis, including a small percentage of people with cystic fibrosis Cystic Fibrosis CF Cystic fibrosis is a hereditary disease that causes certain glands to produce abnormally thick secretions, resulting in tissue and organ damage, especially in the lungs and the digestive tract Kidney transplantation Kidney Transplantation Kidney transplantation is the removal of a healthy kidney from a living or recently deceased person and then its transfer into a person with end-stage kidney failure.
See also Overview of Transplantation Almost everyone with acute pancreatitis has severe abdominal pain in the upper abdomen. When acute pancreatitis is caused by gallstones, the pain usually starts suddenly and reaches its maximum intensity in minutes. When pancreatitis is caused by alcohol, pain typically develops over a few days.
Whatever the cause, the pain then remains steady and severe, has a penetrating quality, and may persist for days. Coughing, vigorous movement, and deep breathing may worsen the pain.
Sitting upright and leaning forward may provide some relief. Most people feel nauseated and have to vomit, sometimes to the point of dry heaves retching without producing any vomit. Often, even large doses of an injected opioid analgesic Opioid Analgesics In some cases, treating the underlying disorder eliminates or minimizes the pain.
For example, setting a broken bone in a cast or giving antibiotics for an infected joint helps reduce pain In acute pancreatitis, a person may develop some swelling in the upper abdomen. This swelling may occur because the intestinal contents have stopped moving, causing the intestines to swell a condition called ileus Ileus Ileus is a temporary lack of the normal muscle contractions of the intestines.
Bloating, vomiting Some people, especially those who develop acute pancreatitis because of alcohol use, may never develop any symptoms other than moderate to severe pain. Other people feel terrible. They look sick and are sweaty and have a fast pulse to beats a minute and shallow, rapid breathing. Rapid breathing may also occur if people have inflammation of the lungs, areas of collapsed lung tissue atelectasis Atelectasis Atelectasis is a condition in which all or part of a lung becomes airless and collapses.
Blockage of the bronchial tubes is a common cause of atelectasis. Shortness of breath can develop if Fluid can accumulate in the pleural These conditions may decrease the amount of lung tissue available to transfer oxygen from the air to the blood and can lower the oxygen levels in the blood. Blood pressure is usually low and tends to fall when the person stands, causing lightheadedness. A pancreatic pseudocyst is a collection of fluid containing pancreatic enzymes that forms in and around the pancreas.
The pseudocyst goes away spontaneously in some people. In other people, the pseudocyst does not go away and can become infected. Necrotizing pancreatitis may occur in severe acute pancreatitis.
In necrotizing pancreatitis, parts of the pancreas may die and body fluid may escape into the abdominal cavity, which decreases blood volume and results in a large drop in blood pressure, possibly causing shock Shock Shock is a life-threatening condition in which blood flow to the organs is low, decreasing delivery of oxygen and thus causing organ damage and sometimes death.
Blood pressure is usually low Severe acute pancreatitis can be life threatening. Infection of an inflamed pancreas is a risk, particularly in people who have necrotizing pancreatitis.
Sometimes, a doctor suspects an infection when a person's condition worsens and a fever develops, especially if this happens after the person's first symptoms started to subside. Organ failure can occur in acute pancreatitis because damage to the pancreas may permit activated enzymes and toxins such as cytokines Cytokines One of the body's lines of defense immune system involves white blood cells leukocytes that travel through the bloodstream and into tissues, searching for and attacking microorganisms and This damage can cause some people who have acute pancreatitis to develop failure of other organs, including the kidneys, lungs, or heart, and this failure can lead to death.
Characteristic abdominal pain leads a doctor to suspect acute pancreatitis, especially in a person who has gallbladder disease or who drinks a lot of alcohol. During the examination, a doctor often notes that the abdomen is tender and the abdominal wall muscles may be rigid. When listening to the abdomen with a stethoscope, a doctor may hear few or no bowel intestinal sounds.
No single blood test proves the diagnosis of acute pancreatitis, but certain tests suggest it. Blood levels of two enzymes produced by the pancreas—amylase and lipase—usually increase on the first day of the illness but return to normal in 3 to 7 days.
If the person has had other flare-ups bouts or attacks of pancreatitis, however, the levels of these enzymes may not increase significantly, because so much of the pancreas may have been destroyed that too few cells are left to release the enzymes. The white blood cell count and blood urea nitrogen level marker of kidney function are usually increased.
X-rays of the abdomen may show dilated loops of intestine or, rarely, one or more gallstones. Chest x-rays may reveal areas of collapsed lung tissue or an accumulation of fluid in the chest cavity. An ultrasound Ultrasound Scanning Ultrasonography of the Abdomen Ultrasound scanning uses sound waves to produce pictures of internal organs see also Ultrasonography. An ultrasound scan can show the size and shape of many organs, such as the liver and pancreas This test is done in all people who have acute pancreatitis to make sure there are no gallstones present that might cause further pancreatitis.
A computed tomography Computed Tomography CT In computed tomography CT , which used to be called computed axial tomography CAT , an x-ray source and x-ray detector rotate around a person. In modern scanners, the x-ray detector usually For this scan, people are also injected with a contrast agent.
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