Health Topics for Digestive System

James A. Clifton Center for Digestive Diseases

Cancers of the Digestive System

Liver Failure Clinic

Liver Service

Pancreatitis

The pancreas is a gland near the liver and stomach. It produces enzymes and hormones such as insulin. Enzymes help to digest food that is eaten. Pancreatitis is an inflammation of the pancreas. There are two main types of pancreatitis. Acute pancreatitis has a very sudden start. Chronic pancreatitis may seem to appear suddenly, but has usually been present for some time.

Acute Pancreatitis:

Alcohol or gallstones cause about 80 percent of acute pancreatitis. About 10 percent may be caused by some medicines, trauma to the abdomen, viral infection like mumps, surgery or it may be inherited. For another 10 percent, the cause is never known. The main symptom is severe upper abdominal pain that starts suddenly and is constant. It is often described as the worse stomachache ever. The pain may feel like it is going through to the back. It is usually worse when lying on the back. Other symptoms include:

• fever
• nausea and vomiting (vomiting does not make the pain better)
• diarrhea and
• bloating

A severe case of pancreatitis can be life threatening, but with hospital care the person usually recovers fully from the illness. If the cause is taken away they may never have another problem. For instance, if the cause is gallstones, the stones will need to be removed.

Treatment of pancreatitis involves not allowing the person any food or liquids for several days, to give the stomach a rest. During this time, the person will receive fluids by intravenous feeding or IV. That means fluids will be given in a needle through a vein in the arm. Medicine for the pain will also be given through the IV. No alcohol will be allowed, even after discharge from the hospital.

Chronic Pancreatitis:

Alcohol abuse is the cause of chronic or long-term pancreatitis about 70 percent of the time. Other causes may include some medicines, family history, or occasionally an acute attack may lead to chronic pancreatitis. As much as 25 percent of the time, no cause is found. Chronic pancreatitis is first found at about ages 30 to 40. It is a progressive disease, in which the pancreas is destroyed. The enzymes from the pancreas start to eat the pancreas itself.

The symptoms may include abdominal pain that goes through to the back. However, the pain may not be present at all, or it may be mild pain that comes and goes. Other symptoms may include diarrhea and weight loss. Pain usually occurs after eating or drinking alcohol. About half of the people with chronic pancreatitis will have diabetes by the time it is discovered. Many times pancreatitis is found when a person is being treated for something else. Sometimes, the person will have severe upper abdominal pain, and go the emergency department. The symptoms can be very much like acute pancreatitis.

If the person with chronic pancreatitis has severe pain, the treatment may be similar to that for acute hepatitis. In addition, the treatment includes controlling the pain, enzyme supplements taken with meals, and a low fat, high carbohydrate diet. Sometimes it may be necessary to eat smaller meals more often. Most important there must be NO alcohol drinking. Antibiotics may be given if an infection develops. Surgery may be necessary to relieve the pain.

The person with chronic pancreatitis may develop malnutrition because they are unable to eat properly. When the pancreas is being destroyed from the enzymes, fats are not easily digested. Often they may have pain after they eat. Other complications include, infection, diabetes, a cyst filled with fluid and tissue, or injury to other organs like the heart, lung, or kidneys. This occurs because of toxins in the blood from the pancreatitis.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIL File DIGE3509.rf2 VRS# 5414 Data Version 7.0 Copyright 1998, 2002 McKesson Health Solutions LLC. All rights reserved.