The pancreas is a long, flat gland in the upper abdomen that produces enzymes that help digestion and hormones that help in glucose metabolism. Pancreatitis is inflammation of the pancreas.

There are two types of pancreatitis:

Acute pancreatitis

Acute pancreatitis is a temporary inflammation of the pancreas that happens in an attempt to recover from a minor, short-term injury. Most people with acute pancreatitis will completely recover in a few days with rest, hydration, and pain relief. 

However, severe cases of acute pancreatitis can be life-threatening.

Chronic pancreatitis

Chronic pancreatitis is a long-term, progressive condition. It happens when the injury or damage to the pancreas is chronic. Constant inflammation of the pancreas can lead to scarring causing pancreatic tissue fibrosis. This results in a decreased ability of the pancreas to produce enzymes and hormones.

Symptoms of acute pancreatitis

  • Fever
  • Increased heart rate
  • Nausea and vomiting
  • Swelling and tenderness in the belly region
  • Pain in the upper part of the abdomen that radiates to the spine.
  • Worsening of symptoms after food consumption.

Symptoms of chronic pancreatitis

  • Apart from symptoms of Acute pancreatitis, chronic pancreatitis can also cause:
  • Diarrhoea and weight loss due to lack of enzymes to digest food.
  • Stomach upset
  • Vomiting

Causes of acute pancreatitis:

  • Trauma or surgery involving the pancreas
  • Autoimmune diseases
  • Metabolic disorders
  • Excessive consumption of alcohol
  • Infections
  • Gallstones
  • Certain medications

Causes of chronic pancreatitis:

  • Increased levels of triglycerides
  • Excessive consumption of alcohol
  • Certain medications
  • Cystic fibrosis
  • Family history of pancreas diseases
  • Gallstones
  • Pancreatitis can have severe complications like:
  • Diabetes, if the condition affects the Langerhans cells
  • Malnutrition due to lack of secretion of digestive enzymes 
  • Pancreatic Infection 
  • Renal failure
  • Pancreatic cancer
  • Pancreatic necrosis due to compromised blood supply to the pancreas 
  • Pseudocysts in which the fluids can be accumulated and result in infection. 

How is pancreatitis diagnosed?

The healthcare provider will check for the wellness of the pancreas with blood tests and imaging tests. 

A pancreatic blood test will give an understanding of the elevated pancreatic enzymes (Like amylase and lipase) in the blood. If the pancreatic enzyme levels are 3X to normal range, it is a suspected case of pancreatitis. 

Diagnosis can be confirmed with a cross-sectional imaging test, like a CT scan or MRI. 

Additional tests to diagnose chronic pancreatitis include a Glucose test Stool elastase test  Fecal fat analysis  Blood tests to assess fat-soluble vitamins

Treatment for acute pancreatitis

Acute pancreatitis may need dietary changes with a low-fat diet or fasting, for the pancreas to recover. Medical management includes the use of antibiotics in case of pancreatic infection, high-dose drugs for pain relief, based on clinical condition. 

If the symptoms don’t subside, doctors may suggest 

Endoscopic retrograde cholangiopancreatography (ERCP), is a procedure that involves the insertion of a tube into the stomach to remove gallstones if they are blocking the pancreatic ducts.

Cholecystectomy (Gallbladder removal surgery) if gallstones are the root cause of  pancreatitis

Pancreas surgery to remove fluid and diseased tissue

Treatment for chronic pancreatitis

In the case of Chronic pancreatitis, doctors may focus on pain relief medications or pancreatic enzyme replacement therapy to restore the digestive ability to digest food and absorb nutrients. 

Dr. Giridhar Reddy
Consultant Gastroenterologist

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