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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Pancreatitis

Symptoms of pancreatitis occur when the pancreas, located just below and behind the stomach, becomes inflamed.

What is it?

Pancreatitis is inflammation of the pancreas, an organ that produces digestive enzymes and hormones (insulin and glucagon). Acute attacks of pancreatitis usually subside within several days to a week but carry the risk of life-threatening complications, including shock and infection in a collection of fluid near the pancreas (pseudocyst). Chronic pancreatitis involving permanent damage to the pancreas may follow recurrent attacks of acute pancreatitis or be due to persistent smoldering inflammation. Possible long-term complications include inadequate absorption of nutrients and diabetes mellitus.

What Causes It?

  • Passage of a gallstone that blocks the pancreatic duct is often a cause of acute attacks.
  • Alcoholism is commonly associated with both acute and chronic pancreatitis.
  • Less common causes of acute attacks: trauma to the pancreas; use of certain drugs (including immunosuppressants, corticosteroids, and sulfa drugs); high triglycerides; viral infection such as mumps.
  • Other causes of chronic pancreatitis: recurrent acute pancreatitis; cystic fibrosis (children);malnutrition.
  • In rare cases pancreatitis is hereditary.
  • In many cases the cause cannot be determined.

Prevention

  • Avoid excessive alcohol use.

Diagnosis

  • Medical history and physical examination.
  • Blood tests.
  • X-ray, ultrasound, or CT (computed tomography).
  • ERCP (endoscopic retrograde cholangiopancreatogram) is done using a thin, lighted, viewing tube (endoscope) passed down the throat and into the small intestine. Contrast material is injected into the bile duct and pancreatic duct and x-rays are taken.
  • Stool (for fat content), pancreatic-function, and other tests help confirm chronic cases.

How to Treat It

  • Acute attacks require hospitalization. The stomach is emptied of its contents, and intravenous fluids and painkillers are given. Patients are not allowed to eat for several days to a week. Antibiotics may be given to treat an associated infection.
  • Surgery to remove gallstones may be necessary.
  • Narcotic painkillers may be needed for severe pain.
  • Alcohol and large, fatty meals should be avoided by those with the chronic form of the illness.
  • Pancreatic enzyme pills are usually prescribed for patients with chronic pancreatitis, to aid in digestion.
  • Insulin may be needed if diabetes develops.
  • Chronic pancreatitis occasionally requires partial or total removal of the pancreas (pancreatectomy) or surgery to deaden the nerves that transmit the pain.

When to Call a Doctor

  • Call a doctor if you have symptoms of pancreatitis.