The pancreas is an organ that can be difficult to deal with when it gets inflamed. How is this condition managed?
Pancreatitis is inflammation of the pancreas in the abdomen. There are several causes for it, of which one particular common cause can be considered preventable. Whether it is mild, moderate, or severe, it is often a tough condition to deal with.
Causes
There are two causes of pancreatitis known to be the most common. Alcohol causes pancreatitis either acutely from binge drinking or chronically through long-term drinking. Gallstones cause pancreatitis when the stone obstructs flow of digestive enzymes from the pancreas through the pancreatic duct, causing these enzymes to back up and act on the pancreas itself. The other causes are relatively uncommon, including high blood triglyceride levels, certain medications, obstructing tumors, viral infections, trauma to the abdomen, and scorpion stings.
Symptoms and Signs
Pancreatitis results in upper abdominal pain with associated pain in the back. This is often accompanied by nausea and vomiting. If pancreatitis is severe, there may be bleeding that results in bruises seen around the belly button (Cullen's sign) and sides of the abdomen (Grey-Turner's sign).
What makes the diagnosis likely is the results of a blood test. The pancreas produces two enzymes called amylase and lipase. With pancreatitis, blood testing would show elevated levels of these enzymes, especially the more pancreas-specific lipase. A CT scan of the abdomen can also demonstrate pancreatitis in action. If a gallstone is the cause, an ultrasound of the abdomen can show the stone plus widening of ducts due to obstruction by the stone.
Treatment
Once the patient is hospitalized, the treatment is simply to wait for the inflammation to die down. In the meantime, the patient is given supportive care with pain medications and intravenous fluids to maintain hydration since it is initially not safe to eat. If there is a suspected gallstone, then a procedure called ERCP can be done. ERCP stands for endoscopic retrograde cholangiopancreatography, the use of a tube with a camera (endoscope) that goes down the esophagus and reaches the first part of the small intestine where a dye is injected into the bile duct (retrograde) so that an x-ray of the abdomen can show the common bile duct and pancreatic duct (cholangiopancreatography). This same procedure is capable of removing gallstones if they are present.
Prognosis
The prognosis depends a lot on how bad the pancreatitis is on admission to the hospital and 48 hours later. The physician looks at the results of particular lab tests plus a few other clinical data to make this determination. In addition, there can be associated complications, such as infection, fluid collection in the pancreas (pseudocyst), elevated blood glucose (hyperglycemia) since production of insulin by the pancreas is impaired, and shock. Overall, pancreatitis can range anywhere from mild to life-threatening. However, if alcohol is the cause of pancreatitis, it may be worth considering cessation of drinking to prevent further episodes.
