Pancreatitis

Pancreatitis

Pancreatitis is inflammation of the pancreas and it is a potentially serious condition.

The pancreas is the organ responsible for producing enzymes that support the digestive process and hormones to regulate the way the body processes sugar.

Pancreatitis can develop suddenly and last for a few days (acute pancreatitis) or it can last for many months or years (chronic pancreatitis). In severe cases, the condition may cause life-threatening complications.

Causes of pancreatitis

Pancreatitis develops when digestive enzymes become activated while they are still within the pancreas, leading to irritation and inflammation.

Repeated bouts of acute pancreatitis cause scar tissue to form in the pancreas, which can lead to digestive problems, diabetes and an increased risk of chronic pancreatitis.

It is not always possible to pinpoint the exact cause of pancreatitis and the risk factors differ between acute and chronic, however a number of factors increase your risk of developing the condition, including:

  • Gallstones
  • Alcohol
  • High blood fat levels
  • Genetic factors, including cystic fibrosis
  • Smoking
  • Autoimmune disease

Symptoms of pancreatitis

Acute pancreatitis can cause:

  • Pain in the upper abdomen that travels around to your back and often feels worse after eating
  • Nausea and vomiting
  • Fever
  • Rapid pulse

Chronic pancreatitis also causes pain in the upper abdomen, accompanied by weight loss and oily, foul-smelling stools.

Serious complications develop as a result of pancreatitis. These include:

  • Kidney failure.
  • Increased risk of pancreatic infection, which may require surgery to remove infected tissue.
  • Pseudocyst, which is a collection of fluid and debris in a cyst-like swelling in your pancreas. If the swelling ruptures it can cause internal bleeding and infection.
  • Diabetes caused by damage to the insulin-producing cells in your pancreas.
  • Dangerously low levels of oxygen in your blood due to chemical changes that affect lung function. This can cause breathing difficulties.
  • Malnutrition, diarrhoea and weight loss due to a reduction in the enzymes your body needs to break down food and process nutrients.
  • Increased risk of pancreatic cancer.
Consultation with a specialist, who can conduct the necessary diagnosis tests, is the first step to better understanding your symptoms.

Diagnosis of pancreatitis

If your doctor suspects pancreatitis, you may be offered a range of different diagnostic tests including:

  • Blood tests.
  • Stool tests. If your stool contains a high level of fat it could indicate that your pancreas isn’t releasing sufficient enzymes to break it down.
  • Imaging including ultrasound, CT and MRI scan to check for inflammation of the pancreas and/or gallstones.
  • EUS, and endoscopic procedure to look for very small bile duct stones 1-2mm in size and exclude structural problems in the bile and pancreatic duct.

Pancreatitis Treatment

The treatment plan will vary according to whether you have acute or chronic pancreatitis and also the extent of the damage.

Treatment typically includes:

  • Medication for pain relief. You may also be referred to the pain clinic or offered surgery to block the nerves that send pain signals to the brain.
  • Enzyme supplements to help your body to break down your food and process nutrients. You will need to take these with every meal.
  • Dietary changes, which will be planned in conjunction with a dietician. Supplementary feeding may be required in the acute or chronic setting to optimise your nutritional status.
  • Endoscopic retrograde cholangiopancreatography (ERCP) is a therapeutic procedure used to maintain drainage of the bile duct when the tissue around it in the head of pancreas is inflamed or scarred or to remove obstructing biliary stones. It can also be used to treat abnormalities in the pancreatic duct including strictures and stones such that drainage of the pancreatic duct enzyme is optimised.
  • EUS can be performed at a therapeutic procedure to drain cystic collections which can develop as a consequence of acute pancreatitis
  • Pancreatic surgery may be necessary to remove damaged tissue or drain fluid. If your pancreatitis was caused by gallstones, you may be given surgery to remove your gallbladder (cholecystectomy).
  • If your pancreatitis is the result of an addiction to alcohol you may be offered treatment to help you to reduce your dependence. Continuing to drink alcohol while suffering from the condition could lead to serious long-term health problems.
  • Other conditions such as autoimmune pancreatitis/IgG4 disease will require immunosuppressive medication.

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A consultation with a specialist to discuss the necessary diagnostic tests is the first step.