Pancreas illustration (320x240)
The pancreas is an oblong flattened gland, about six inches long, located deep in the abdomen. Illustration by Scott Weldon.

Pancreatitis is inflammation of the pancreas. The pancreas is a long and flat gland that produces enzymes that help digest food and hormones that help control how the body uses sugar. The pancreas is located in the upper abdomen, behind the stomach.

Pancreatitis occurs when digestive enzymes produced in the pancreas become activated before they are released into the small intestine. The enzymes attack the pancreas causing damage which then triggers an inflammatory response. This response can cause further damage, unless it is treated appropriately.

Pancreatitis can occur in two forms: acute and chronic.                  

Acute pancreatitis: it appears suddenly and lasts for days.

Chronic pancreatitis: occurs for many years.

Causes of pancreatitis

Acute pancreatitis: gallstones and alcoholism account for most cases. Other factors are trauma and infections. Some cases are hereditary.

Chronic pancreatitis: years-long consumption of alcohol; it is more common in heavy drinkers. Having recurrent episodes of acute pancreatitis for several years typically results in chronic pancreatitis.

Signs and symptoms of pancreatitis

Acute pancreatitis: severe pain, generally after a big meal. The pain is usually on the top section of the abdomen, right below the ribs, but can occur anywhere in the abdomen or lower chest. The pain may be felt through the back. Nausea and vomiting can also occur.

Chronic pancreatitis: the symptoms may be identical to those of acute pancreatitis: pain in the abdomen that can be felt through to the back; nausea or vomiting. The pain sometimes is severe and can last for many hours or several days. Patients may lose their appetite or don’t eat because of the pain, and lose weight.

Diagnosis of pancreatitis

Acute pancreatitis

Diagnosis of acute pancreatitis may involve various tests

  • Blood tests to determine whether the levels of pancreatic enzymes lipase and amylase are elevated
  • Computed tomography (CT) scan of the pancreas
  • Ultrasound of the abdomen to confirm the presence of gallstones
  • Magnetic resonance cholangiopancreatography (MRCP) to determine whether the pancreatic duct is affected

Chronic pancreatitis

Diagnosis of chronic pancreatitis may involve various tests:

  • Test for pancreatic function, such as the secretin-cerulein test, Lundh test, and excretion of pancreatic enzymes in the feces
  • Imaging studies, such as computed tomography and ultrasound, to detect alterations in the structure of the pancreas
  • Blood tests to measure the levels of β-globulin or immunoglobulin

Treatment of pancreatitis

Acute pancreatitis

Treatment depends on the severity of the disease. 

Mild cases can be treated in an outpatient setting. 

Antibiotics are not recommended.

Patients with severe disease are transferred to the intensive care unit for:

  • Observation to assess the severity of the disease
  • Receiving necessary fluids
  • Receiving nourishment through a tube that goes from the nose into the small intestine

Chronic pancreatitis

The treatment of chronic pancreatitis aims at managing the digestive problems and relieving the pain:

  • Provide replacement for pancreatic enzymes
  • Provide proper nutrition and vitamin supplements
  • Control blood sugar
  • Provide medications to relieve pain
  • Stop consuming alcohol and smoking tobacco