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What is the pancreas?

The pancreas, located in the abdomen, is responsible for the production of digestive juices and the hormones insulin and glucagon. Inflammation of the pancreas leads to a condition called pancreatitis.

What is acute pancreatitis?

Acute pancreatitis is when people get a sudden attack of upper abdominal pain (which is often severe) with vomiting, nausea or bloating.  The pancreas may be inflamed most commonly by excessive alcohol, gallstones, medications, autoimmune condition (an inflammatory condition where the bodies defence mechanisms attacks the pancreas) or medical tests (especially ERCP).  In 10% of people no cause can be found.

The attack may last a few days, but can last for several weeks, in severe complicated cases, and can be life threatening.  Severe pain and vomiting usually means admission to hospital is required.

What are the tests for acute pancreatitis?

A simple blood test can confirm pancreatitis in most cases.  USS, CT or MRI scans may be required to determine the cause and severity of acute pancreatitis.

How is acute pancreatitis treated?

In over 95% of cases pain relief and fluid thro drip are required, while the pancreas heals itself.  Patients will need to rest the pancreas, meaning not eating to stop the production of digestive enzymes from the pancreas, until it recovers.

There is no specific treatment for acute pancreatitis.

What are the complications of pancreatitis?

Fluid collections - Fluid collections around the pancreas can form during an acute attack.  These can become infected or form a thick wall.  When a thick wall has formed around a collection of fluid this is called a pseudocyst.  If this doesn’t shrink on its own, then it may need draining (see pancreatic cysts)

Blood clots - blood clots either in the legs or lungs can occur in pancreatitis.  Blood clots can also occur in the blood vessels immediately adjacent to the pancreas.

Necrosis - necrosis means that parts of the pancreas may lose their blood supply and die.  Infection often complicates necrosis and this may require a drain to be placed in the pancreas or even an operation.

Will I get pancreatitis again?

This depends on the cause of the pancreatitis.  If the cause is alcohol, then refraining from alcohol should reduce the risk of it happening again.  If the cause is gallstones them removing the gallbladder is the best treatment. 

What happens if I keep on getting pancreatitis?

Multiple episodes of pancreatitis can lead to scarring of the pancreas.  This is called chronic pancreatitis.

What is chronic pancreatitis?

Chronic pancreatitis is when multiple attacks of acute pancreatitis have caused scarring to the pancreas.  This process usually occurs over years.

What are the signs and symptoms of chronic pancreatitis?

Abdominal pain and bloating over a long period can be a sign of chronic pancreatitis.  Weight loss may occur if patients are unable to eat or unable to digest their food (due to lack of digestive enzymes).  Bowel motions can become pale, fatty and floating. Yellowing of the eyes can occur and diabetes can develop.

What are the causes of chronic pancreatitis?

The cause of chronic pancreatitis is mainly repeated episodes of acute pancreatitis until the scarring in the pancreas itself becomes the cause, a kind of vicious circle.

How is chronic pancreatitis treated?

Treatment is not standardised and is tailored to each patient and the problems encountered.  The cause of the initial pancreatitis may need to be addressed (alcohol, gallstones, medication, etc.)  Symptom management is the hallmark of treatment.  Pain relief (tablets, injections or nerve blocks), digestive enzyme replacement and nutrition are commonly required.  Occasionally endoscopic procedures or surgery is required for blockages to the output of the pancreas.