Saanichton, BC

Dr. Miguel A. Lipka

Pancreatitis

This is categorized under:

Pancreatitis is inflammation of the pancreas that can occur in two very different forms. Acute pancreatitis is sudden while chronic pancreatitis is characterized by recurring or persistent abdominal pain with or without steatorrhea (the presence of excess fat in the feces) or diabetes.

Symptoms include:

  • Severe upper abdominal pain, with radiation through to the back
  • Nausea and vomiting
  • High blood pressure (when pain is prominent)
  • Low blood pressure if internal bleeding or dehydration has occurred
  • Both the heart and respiratory rates are elevated
  • Abdominal tenderness is usually found but may be less severe than expected given the patient's degree of abdominal pain

The treatment of pancreatitis is supportive and depends on the severity of the pancreatitis itself. They include:

  • Pain relief
  • Intravenous replacement fluids and salts
  • Limitation of oral intake (with dietary fat restriction)
  • Monitoring and assessment for, and treatment of, the various complications
  • Endoscopic retrograde cholangiopancreatography (ERCP) if gallstone pancreatitis

Acute Pancreatitis

Acute pancreatitis usually begins with a sharp, severe pain in the upper abdomen that may last for a few days. It may be constant pain that is just in the abdomen or it may reach to the back and other areas. The pain may be sudden and intense or it may begin as a mild pain that is aggravated by eating and slowly gets worse. In addition, the abdomen may be swollen and very tender. Other symptoms may include nausea, vomiting, fever and an elevated pulse.

The most common cause of acute pancreatitis is the presence of gallstones—small, pebble-like substances made of hardened bile—that cause inflammation in the pancreas as they pass through the common bile duct.

Chronic Pancreatitis

Most people with chronic pancreatitis experience pain in the back and abdomen. In some cases, abdominal pain goes away as the condition advances, probably because the pancreas is no longer making digestive enzymes.

Weight loss is often a symptom of chronic pancreatitis because the body does not secrete enough pancreatic enzymes to break down food and nutrients are not absorbed normally. Poor digestion leads to excretion of fat, protein and sugar in the stool. If the insulin-producing cells of the pancreas have been damaged, diabetes may develop.

Excessive alcohol use is the most common cause of chronic pancreatitis.