Acute Pancreatitis

The pancreas is a large gland located behind your stomach. It produces (secretes) enzymes. These enzymes help digest food. The pancreas also releases the hormones glucagon and insulin. These hormones help regulate blood sugar. When the pancreas becomes inflamed, the disease is called pancreatitis. Inflammation of the pancreas occurs when enzymes from the pancreas begin attacking and digesting the pancreas.

CAUSES

Most cases of sudden onset (acute) pancreatitis are caused by:

  • Alcohol abuse.

  • Gallstones.

Other less common causes are:

  • Some medicines.

  • Exposure to certain chemicals.

  • Infection.

  • Damage caused by an accident (trauma).

  • Abdominal surgery.

SYMPTOMS

Acute pancreatitis usually begins with pain in the upper abdomen and may radiate to the back. This pain may last a couple days. The constant pain varies from mild to severe. The acute form of this disease may vary from mild, nonspecific abdominal pain to profound shock with coma. These patients become dehydrated and develop low blood pressure. In severe cases, bleeding into the pancreas can lead to shock and death. The lungs, heart, and kidneys may fail.

DIAGNOSIS

Your caregiver will form a clinical opinion after giving you an exam. Laboratory work is used to confirm this diagnosis. Often, a digestive enzyme from the pancreas (serum amylase) and other enzymes are elevated. Sugars and fats (lipids) in the blood may be elevated. There may also be changes in the following levels: calcium, magnesium, potassium, chloride, and bicarbonate (chemicals in the blood). X-rays, a CT scan, or ultrasound of your abdomen may be necessary to search for other causes of your abdominal pain.

TREATMENT

Most pancreatitis requires treatment of symptoms. Most acute attacks last a couple of days. Your caregiver can discuss the treatment options with you.

  • If complications occur, hospitalization may be necessary for pain control and intravenous (IV) fluid replacement.

  • Sometimes, a tube may be put into the stomach to control vomiting.

  • Food may not be allowed for 3 to 4 days. This gives the pancreas time to rest. Giving the pancreas a rest means there is no stimulation that would produce more enzymes and cause more damage.

  • Antibiotic medicines may be given if infection is the cause.

  • Sometimes, surgery may be required.

  • Following an acute attack, your caregiver will determine the cause, if possible, and offer suggestions to prevent recurrences.

HOME CARE INSTRUCTIONS

  • Eat smaller, more frequent meals. This reduces the amount of digestive juices the pancreas produces.

  • Decrease the amount of fat in your diet. This may help reduce loose, diarrheal stools.

  • Drink enough fluids to keep your urine clear or pale yellow. This is to avoid dehydration which can cause increased pain.

  • Talk to your caregiver about pain relievers or other medicines that may help.

  • Avoid anything that may have triggered your pancreatitis, such as alcohol.

  • Follow the diet advised by your caregiver. Do not advance the diet too soon.

  • Take medicines as prescribed.

  • Get plenty of rest.

  • Check your blood sugar at home as directed by your caregiver.

  • If your caregiver has given you a follow-up appointment, it is very important to keep that appointment. Not keeping the appointment could result in a lasting (chronic) or permanent injury, pain, or disability. If there is any problem keeping the appointment, you must call to reschedule.

SEEK MEDICAL CARE IF:

  • You are not recovering in the time described by your caregiver.

  • You have persistent pain, weakness, or feel sick to your stomach (nauseous).

  • You have recovered and then have another bout of pain.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You are unable to eat or keep fluids down.

  • Your pain increases a lot or changes.

  • You have a fever.

  • Your skin or the white part of your eyes look yellow (jaundice).

  • You develop vomiting.

  • You feel dizzy or faint.

  • Your blood sugar is high (over 300 mg/dL).

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.