Stephanie Ray, RN, BSN
What is Pancreatitis?
Pancreatitis is inflammation in your pancreas. It's usually temporary (acute) but can also be lifelong (chronic). The most common symptom is abdominal pain. The most common causes are heavy alcohol use and gallstones.
Pancreatitis can occur when the pancreas swells and becomes inflamed. This can happen when the digestive juices (enzymes) attack the pancreas. The pancreas is a small gland behind your stomach on the left side of your abdomen.
The pancreas has two main functions:
It makes digestive juices (enzymes) and sends them to your small intestine to help break down food.
It makes hormones (glucagon and insulin) that control blood sugar levels.
Pancreatitis can be sudden (acute) or ongoing (chronic)
Acute pancreatitis
Sudden inflammation which lasts for a short time
The pancreas can return to normal after healing but repeated episodes of acute pancreatitis can lead to chronic
It may cause serious problems or be deadly in severe cases
Chronic pancreatitis
Long-lasting inflammation that comes and goes over time
Causes permanent damage to the pancreas
Often causes scarring of pancreatic tissue
In severe cases, it may cause the pancreas to stop making digestive juices and insulin
Causes
The most common causes are:
Heavy drinking
Gallstones can block the pancreatic duct so the digestive juices cannot be released
Other causes
Abdominal injury or surgery
High levels of fat (triglycerides) in your blood
Very high levels of calcium in your blood
Certain medications that can irritate the pancreas
Infections like viruses
Complications of Cystic Fibrosis
Cancer
Hereditary pancreatitis (inherited)
Congenital abnormalities in the pancreas
Trauma to the pancreas
Cigarette smoking
Signs and Symptoms
Each person's symptoms may vary but they may include:
Severe abdominal pain that may spread to your back or chest (can feel worse after you eat)
Fatty poops that leave an oily film in the toilet
Nausea
Vomiting
Rapid heart rate
Fever
Swelling and feeling sore or tender in your upper belly
Fluid build up in your belly
Lowered blood pressure - lightheadedness
Yellowing of the skin and eyes (jaundice)
Diagnosis
Your provider will give you a physical exam and review your past medical history. Blood, urine, and stool tests are done. Imaging tests may also be done, including:
Abdominal X-ray: images of internal tissues, bones, and organs
Ultrasound: uses sound waves to see the internal organs in your belly and checks how blood is flowing through different vessels
Endoscopic Ultrasound (EUS)- an internal ultrasound performed while you are sleeping where a flexible tube (endoscope) is inserted into your mouth
ERCP (endoscopic retrograde cholangiopancreatography): Uses an X-ray and a small tube with a camera while you are asleep. The small tube is guided down your esophagus (food pipe) through your stomach and into the first part of your small intestine. A dye can be put into your bile ducts with this tube to make them easier to see with an X-ray
CT scan: an imaging test that shows detailed images of internal body parts. The CT images are more detailed than X-rays and can show bones, muscles, fat, and organs.
MRCP (magnetic resonance cholangiopancreatography): An MRI takes detailed images of your pancreas, gallbladder, and pancreatic ducts.
Treatment
The goal is to REST your pancreas and give it time to heal
In most cases, you will be in the hospital for a few days
You will be given IV fluids (intravenous)
You will be given pain medications and antibiotics
In mild cases, you may tolerate eating clear liquids or a low-fat diet.
In more severe cases, you may not be able to eat or drink for a few days as your pancreas heals and a feeding tube may need to be placed.
Pancreatitis usually gets better in a few days but if problems persist, additional treatment may include:
NG tube (nasogastric): With persistent vomiting, this small tube is passed down through your nostril to your stomach to help remove any fluid and air. This way your pancreas can rest. This tube can also be used to feed you.
ERCP (endoscopic retrograde cholangiopancreatography): Uses an X-ray and a small tube with a camera while you are asleep. The small tube is guided down your esophagus through your stomach and into the first part of your small intestine. A dye can be put into your bile ducts with this tube to make them easier to see with an X-ray. The tube has tools that can remove fluid, blockages, and gallstones. Stents (tubes) can also be placed to keep ducts open.
Surgery to remove gallstones or your gallbladder.
Sources
https://my.clevelandclinic.org/health/diseases/8103-pancreatitis
https://www.hopkinsmedicine.org/health/conditions-and diseases/pancreatitis#:~:text=points%20about%20pancreatitis-,Pancreatitis%20is%20the%20swelling%20(inflammation)%20of%20the%20pancreas.,pancreas%20and%20let%20it%20heal. Assessed and Endorsed by the MedReport Medical Review Board