Table of Contents
Between them, excessive ALCOHOL consumption and gallstones account for more than 80 percent of pancreatitis. Other causes include CYSTIC FIBROSIS, viral INFECTION (notably with the MUMPS VIRUS), SIDE EFFECTS of certain medications, and trauma to the abdomen (particularly blunt trauma such as might occur in MOTOR VEHICLE ACCIDENTS). A good deal of the time doctors cannot identify the cause of pancreatitis.
Symptoms of Pancreatitis and Diagnostic Path
Acute pancreatitis makes a person very ill, with symptoms that include moderate to severe ABDOMINAL PAIN, ABDOMINAL DISTENTION; NAUSEA, VOMITING, and FEVER. Often the PULSE and respiration rate are rapid. When symptoms are severe, the person may be in SHOCK, which is a life-threatening emergency. The diagnostic path includes BLOOD tests to measure the levels of the DIGESTIVE ENZYMES amylase and lipase, which become significantly elevated with pancreatitis. ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP) can often identify signs of inflammation and can help determine whether gallstones are obstructing the BILE DUCTS, a common cause of acute pancreatitis. ULTRASOUND or COMPUTED TOMOGRAPHY (CT) SCAN also can provide therapeutically useful information.
People who have chronic pancreatitis may have intermittent upper ABDOMINAL PAIN, though with advanced damage to the pancreas pain is less common. The primary symptom of chronic pancreatitis is persistent weight loss despite adequate eating. This occurs because the damaged pancreas is unable to produce the digestive enzymes the SMALL INTESTINE needs to absorb nutrients, so consumed food passes through the gastrointestinal tract largely useless in the context of meeting the body’s NUTRITIONAL NEEDS. The same procedures doctors use to diagnose acute pancreatitis help diagnose as well as monitor chronic pancreatitis. Specialized tests also can measure production of pancreatic enzymes.
Pancreatitis Treatment Options and Outlook
Treatment for acute pancreatitis is primarily supportive, with intravenous fluids to restore fluid and electrolyte balance within the body as well as to deliver GLUCOSE. Surgery becomes necessary when there is bleeding in the pancreas. Though illness can be severe, most people recover without residual consequences. Some people do subsequently develop chronic pancreatitis. Other complications may include RENAL FAILURE and the development of fluid-filled pockets called pseudocysts that often become infected.
Treatment for chronic pancreatitis is elimination of any contributing factors (such as alcohol consumption or removal of gallstones), plus a high-carbohydrate, low-fat diet to get basic nutrients into the body. Enzyme supplements can improve digestion. Complications include DIABETES (requiring INSULIN THERAPY) and progressive loss of pancreatic function.
Risk Factors and Preventive Measures
Excessive alcohol consumption and gallstones are the leading risk factors for pancreatitis; alcohol abstinence and appropriate treatment for gallstones eliminates them. Other causes of pancreatitis are less defined and thus more difficult to prevent. Prompt medical assessment of symptoms and appropriate treatment improve the likelihood for uneventful recovery.