Acute pancreatitis is an inflammation of the pancreas that occurs suddenly.
The pancreas is a large gland located behind the stomach in the upper abdomen. It is responsible for the production of digesting enzymes and hormones.
Pancreatitis occurs when enzymes normally released into the digestive tract begin to cause damage to the pancreas. The gland swells and becomes inflamed. Enzymes are released into the surrounding tissues and circulation in greater quantities. More enzymes are released into the bloodstream and surrounding tissues.
As a result, digestion becomes slow and painful. Additional bodily functions may be impacted. If attacks are severe, prolonged, or frequent, the pancreas can become permanently damaged and scarred.
It is unknown precisely why the enzymes begin to cause harm to the pancreas. However, there are a number of known causes of acute pancreatitis.
Gallstones are one of the most common causes of acute pancreatitis. Gallstones that pass through the gallbladder may obstruct the pancreatic duct. (From the pancreas to the small intestine, the pancreatic duct transports digestive enzymes.) Enzymes cannot flow normally when the pancreatic duct becomes clogged. They have a tendency to back up into the pancreas. This results in inflammation of the pancreas.
Another frequent cause of acute pancreatitis is a complication of an endoscopic retrograde cholangiopancreatography (ERCP) surgery. An endoscope is used to perform ERCP. This is a flexible tube with one end equipped with a small camera and a light and the other with an eyepiece. ERCP is used to visualize pancreatic ducts, liver, and gallbladder and to diagnose stones and tumors. The other major cause of pancreatitis is excessive alcohol consumption. The vast majority of people who consume alcohol never get pancreatitis. However, certain individuals will develop pancreatitis as a result of excessive alcohol consumption. Alcohol consumption can occur over time or in a single binge. Combining alcohol and smoking raises the risk of developing acute pancreatitis.
Pancreatitis can also be caused by the following factors:
Usage of a wide variety of medications, including Sulfa medications
Water pills (hydrochlorothiazide, others)
Immunosuppressive medications (azathioprine)
HIV medications
Abdominal surgery
Catastrophic trauma
Metabolic problems, such as elevated calcium or lipid levels in the blood
Certain infections, for example, mumps or viral hepatitis
Often, no reason can be identified.
Symptoms
Upper abdominal pain is the most prevalent sign of acute pancreatitis. It might be mild to severe.
The pain is typically felt in the center of the body, directly beneath the ribs. However, it might be felt on either the left or right side at times. This is a continuous, drilling, or "boring" type of pain. Radiating pain may occur in the back, flank, chest, or lower abdomen.
Pain reaches its peak severity rapidly, frequently within 30 minutes. The pain associated with alcohol-induced pancreatitis typically begins one to three days following a binge.
Finding a comfortable position may be challenging. By bending over or sleeping on your side, you may be able to alleviate the pain. Generally, eating worsens the pain.
Additional symptoms of acute pancreatitis include the following:
Vomiting and nausea
Appetite loss
Bloating in the abdomen
Fever, trouble breathing, weakness, and shock may develop in severe cases.
Diagnosis
Your doctor will make the diagnosis of acute pancreatitis based on the following:
Your signs and symptoms
A physical examination
Certain laboratory examinations
Blood tests typically demonstrate elevated levels of two pancreatic enzymes.
A computed tomography (CT) scan may be performed in some instances. The scan can detect pancreatic swelling and fluid collection in the belly.
Additionally, the scan may reveal whether you have pancreatic pseudocysts. Pseudocysts are enzyme-filled sacs. They occur in some situations of severe pancreatitis or following a series of attacks. Severe complications can occur if the pseudocysts rupture and spill enzymes onto exposed tissues.
An ultrasound of the gallbladder may be performed if gallstones are suspected.
Expected Timeframe
Mild to moderate pancreatitis frequently resolves spontaneously within a week. Severe cases, on the other hand, can last for several weeks.
Chronic pancreatitis can develop if the pancreas sustains extensive damage in a single severe attack or a series of recurring attacks.
Prevention
Avoiding excessive alcohol use can help prevent pancreatitis. Anyone who has already experienced one episode of alcohol-induced pancreatitis should abstain from alcohol totally. This is critical in order to avoid the problem of relapsing or becoming chronic.
The majority of acute pancreatitis episodes that are not caused by alcohol usage cannot be prevented. Preventing gallstones, on the other hand, may help avoid gallstone-related acute pancreatitis. To aid in the prevention of gallstones, it is recommended that you maintain a healthy weight and avoid fast weight loss.
If gallstones are the cause, gallbladder surgery is frequently recommended to prevent future attacks. When medicine is suspected to be the reason, it will be discontinued as soon as possible.
Treatment
If you suspect that you have acute pancreatitis, refrain from eating or drinking anything until you consult a physician. Food and drink stimulate the pancreas to produce enzymes. This will exacerbate the pain.
The majority of patients who develop pancreatitis are hospitalized. They are administered pain medications and intravenous hydration.
You will be unable to eat or drink until your symptoms ease. In the majority of situations, there is little that can be done to speed healing or shorten an episode. If the episode lasts longer than a week and the patient is unable to eat, nutrients may be administered intravenously.
Antibiotics may be administered in some instances. These will aid in the prevention and treatment of infection in the pancreas or adjacent tissues. In the majority of situations, no further medication is required.
In rare instances, surgery may be required to: If you suffer from pancreatitis caused by gallstones, you may require an ERCP. During the test, the doctor may make a small incision in the bile duct opening to treat an existing or impending blockage. Your gallbladder will almost certainly be removed. This is typically performed days to weeks after the pancreatitis episode has resolved. Immediate surgery is technically more challenging and may worsen pancreatitis.
Drain a pseudocyst
Take care of an abscess
Stop the bleeding.
When Should You Talk to A doctor?
If you develop any of the following symptoms, contact your doctor or go to the nearest hospital emergency room:
Abdominal pain that persists for more than 30 minutes
Suffering from the pain that is accompanied by vomiting or severe nausea
Prognosis
Complications occur in a tiny minority of patients. These include a pseudocyst or pancreatic abscess. They may require additional monitoring or treatment.
Pancreatitis induced by excessive alcohol consumption is prone to recur if drinking is continued. The pancreas may sustain lasting damage over time. There is a possibility that a chronic version of the disease will emerge.
