A B C D E F G H I J K L M N O P R S T U V W

PANCREATITIS : ACUTE

What is Acute Pancreatitis ?

The pancreas (sweetbread) is a gland which lies in the back of the upper abdominal cavity. The gland has two main functions. It produces an enzyme to help digest certain types of food in the gut, particularly fats. The second is to produce the hormone insulin which controls the level of glucose in the body cells. Pancreatitis results from partial damage to the pancreas itself by its own enzymes. As a result of this, severe abdominal pain and vomiting may result. The chronic inflammation of the pancreas gland often produces pain in the upper abdomen and back.

Why does Acute Pancreatitis occur ?

Acute pancreatitis usually occurs either in patients with gallstones, or those who drink excessive amounts of alcohol. Rarely it can be a result of direct injury, or occur in patients with abnormal amounts of fat (cholesterol and similar chemicals) in the blood. It can also be a consequence of other infections. Gallstones can prevent the digestive enzymes produced by the pancreas from flowing into the intestine. They leak out and damage the pancreas. Too much alcohol has a direct damaging effect on the pancreas.

Treatment Involved for Acute Pancreatitis

You will have been admitted to hospital. The diagnosis may be confirmed by a blood test. An ultrasound examination of the gall-bladder and pancreas will be performed early during the admission to confirm the diagnosis and to look for the presence of gallstones. This technique uses a type of sound wave to record a radar-like picture of the organs of the abdomen. Treatment requires the relief of pain with strong painkillers given by injection. An intravenous drip provides fluids and essential chemicals, so that food and fluid can be withheld in order to rest the pancreas. Sometimes a thin tube passed through the nose into the stomach is necessary to empty the stomach. Progress is monitored by blood tests. As the pain begins to improve, fluids by mouth will be gradually restarted and eventually more solid food. The average length of hospital stay is between 1 and 2 weeks. If gallstones are diagnosed, arrangements will be made for the patient to return for removal of the gall-bladder and gallstones. If alcohol was thought to be the trigger, it is essential to keep off alcohol permanently. For those with a long-standing alcohol problem, contact will be established with a support group either Alcoholics Anonymous or ACCEPT.

During Treatment for Acute Pancreatitis

The usual period in hospital is 1 2 weeks. Although there are no complications of treatment, pain may flare up on commencing a normal diet. Rarely an acute pancreatitis may affect the lungs. Then oxygen may be required. Cysts may occur near the pancreas and require operation. In severe pancreatitis the ability of the pancreas to produce insulin may be reduced. Thus, insulin may be required in a very few cases to treat the diabetes which results from this.

After Treatment for Acute Pancreatitis

A further attack may occur following discharge from hospital. Any abdominal pain should be reported to the doctor. If gallstones were the trigger agents, a low-fat diet will be advised until surgery to remove the gall-bladder can be performed. In particular, fried and spicy foods need to be avoided. If alcohol was the cause, total abstinence from alcohol is essential if a further attack is to be avoided. There is some evidence that treating abnormal blood fat levels (if present) can reduce the likelihood of recurrence.

If Acute Pancreatitis is Left Untreated

Acute pancreatitis may be complicated by the development of abscesses near the pancreas. Fluid can collect in the abdomen cavity as a result of inflammation of the pancreas. This may require drainage. Further attacks of pancreatitis may occur unless the underlying cause is treated. In such repeated or bad attacks, the pancreas may be severely damaged and permanent diabetes may result.

Effects on Family of Acute Pancreatitis

A change of diet is usually needed. The cook in the family may need the advice of a dietitian. If the underlying cause is gallstones, the diet should be continued until the gallstones are removed. If alcohol is the cause, support of family and friends will be essential, to help you abstain from alcohol.