The pancreas is an organ in the left and middle part of the upper abdomen which makes hormones and digestive enzymes to help break down food. The pancreas helps us break down fats, proteins, and carbohydrates into smaller molecules that can be absorbed by the body. It also secretes insulin to help sugar get into the cells for energy. When the pancreas becomes irritated, this is called “pancreatitis.”
Pancreatitis has symptoms that can vary from person to person. The most common symptom of pancreatitis is sudden, severe upper abdominal pain that radiates to the back in a band-like pattern. It can also lead to nausea and vomiting. In severe cases, pancreatitis can lead to shock, with low blood pressure and high heart rate.
There are many different causes of pancreatitis. The two most common causes are alcohol use and gallstones, which are present about 60-75% of the time. The gallbladder and the pancreas share a drainage duct called the common bile duct, and sometimes stones from the gallbladder can get lodged in this common bile duct, causing irritation of the pancreas. Alcohol can also cause irritation of the pancreas, particularly in patients with long-term alcohol abuse. Other causes of pancreatitis can include new medications, such as hydrochlorothiazide, mesalamine, sulfasalazine, azathioprine, certain antibiotics, estrogen, aspirin, and calcium. Anatomical variants, strictures of the duodenum, or pancreatic cancers can cause pancreatitis as well. High triglycerides (cholesterol), which can be hereditary or diet-related, can contribute. About 20% of the time, no underlying cause can be identified. This is called idiopathic pancreatitis.
Pancreatitis is diagnosed by having two of the following three findings:
- Typical abdominal pain, in the epigastrium and radiating to the back
- Three-fold or more elevation in pancreatic enzyme value in the blood (lipase level)
- Inflammation of the pancreas on CT, ultrasound, or MRI scan
Treatment of pancreatitis depends on the severity. If the pancreatitis is mild, usually supportive care is enough, including nothing by mouth (to give the pancreas time to rest), IV fluids, and pain control. If the pancreatitis is severe, sometimes feedings through a tube are necessary to give adequate nutrition and still allowing the pancreas to rest. If pancreatitis is from gallstones, after pancreatitis resolves, it is recommended to have the gallbladder removed to prevent further attacks. Most of the time, antibiotics are not necessary unless there is an abscess or another reason to suspect acute infection as the cause of pancreatitis. If the patient is a heavy alcohol drinker, it is recommended that they have alcohol abuse counseling and support groups to help them stop drinking alcohol.
Article by Elizabeth “Libby” Greenwood, PA-C. Learn more about her here: https://digestivehealth.ws/provider/elizabeth-greenwood-pa-c/
Digestive Health Specialists, PA is here to help if you, or someone you know, would like more information, or if you are experiencing any of the above symptoms and would like further evaluation. To make an appointment, feel free to give us a call at 336-768-6211.