Pancreatitis

The main symptom of sudden (acute) pancreatitis is sudden moderate to severe pain in the upper area of the belly (abdomen). Pain may also spread to your back.

Sometimes the pain is mild. But the pain may feel as though it bores through the belly to the back. Sitting up or leaning forward sometimes eases the pain. Other symptoms of an attack of pancreatitis are:

• Nausea and vomiting.
• Fever.
• Fast heart rate.
• Sweating.
• Yellowing of the skin or the whites of the eyes (jaundice).
• Shock.

Long-term (chronic) pancreatitis also causes pain in the upper belly.

Other conditions that have similar symptoms include bowel obstruction, appendicitis, cholecystitis, peptic ulcer disease, and diverticulitis.

Most of the time, acute pancreatitis is caused by gallstones or by alcohol use. Gallstones can block the flow of enzymes from the pancreas into the intestines. Alcohol can injure the pancreas. The amount of alcohol needed to cause this type of pancreatitis may be different for each person. It may happen after a drinking binge. Or it may happen after many episodes of heavy drinking.

Other causes of acute pancreatitis may include:

• Infections, including mumps.
• Some medicines. These include certain antibiotics, steroids, and blood pressure medicines.
• Injury, such as trauma to the belly.
• Very high fat level (triglycerides) in the blood.

Sometimes the cause isn't known.

You can lower your risk for chronic pancreatitis by avoiding alcohol. Alcohol use is the most common cause of chronic pancreatitis. It is very important that you not drink any alcohol. If you drink even small amounts, it can cause severe pain and problems. If you drink large amounts of alcohol when you have chronic pancreatitis, it can shorten your life.

You can't fully prevent chronic pancreatitis caused by gallstones. But you may be able to lower your risk for gallstones. To do this, it's important to stay at a weight that's healthy for you, be active, and eat healthy low-fat foods.

If you smoke, you may lower your risk for chronic pancreatitis if you quit.

If your doctor thinks that you have chronic pancreatitis, they will ask questions about your symptoms and history of pancreatitis and do a physical exam. You may have blood tests to see if your levels of pancreatic enzymes are higher than normal.

Your doctor may also do a CT scan of your belly to look for scarring and other signs of damage of the pancreas. Sometimes a special MRI test called magnetic resonance cholangiopancreatography (MRCP) is used.

Most attacks of acute pancreatitis need treatment in the hospital. Your doctor will give you pain medicine and fluids through a vein (I.V.). You'll get these until the pain goes away.

Based on what caused the pancreatitis, you may need to stop drinking alcohol. And you may need to make changes to your diet, like eating low-fat foods. Changes like these help lower your risk for future attacks.

If gallstones are causing pancreatitis, you may need endoscopic retrograde cholangiopancreatogram (ERCP). It's a procedure to remove the stones if they don't pass on their own. You may need surgery to remove your gallbladder.

Most people get well after an attack of pancreatitis. But problems can happen. Problems may include cysts and infection. Or some of the tissue in the pancreas might die. Surgery may be done to remove a part of the pancreas that has been damaged. This surgery isn't common.

If you have chronic pancreatitis caused by alcohol use, you'll need to quit drinking to reduce severe pain and other problems that can happen (complications). If you drink large amounts of alcohol when you have chronic pancreatitis, it can shorten your life.

It's not clear how your diet might affect pancreatitis. But doctors recommend that you eat low-fat foods and stay at a healthy weight.