The pancreas is an organ behind the stomach. It makes hormones like insulin that help control how your body uses sugar. It also makes enzymes that help you digest food.
Usually these enzymes flow from the pancreas to the intestines. But if they leak into the pancreas, they can irritate it and cause pain and swelling. When this happens suddenly, it's called acute pancreatitis.
Most of the time, acute pancreatitis is caused by gallstones or by heavy alcohol use. But several other things can cause it, such as:
The main symptom is pain in the upper belly. The pain can be severe. You also may have a fever, nausea, or vomiting. Some people get so sick that they have problems breathing. They also may have low blood pressure.
Your doctor will diagnose pancreatitis with an examination and by looking at your lab tests. Your doctor may think that you have this problem based on your symptoms and where you have pain in your belly.
You may have blood tests of enzymes called amylase and lipase. In pancreatitis, the level of these enzymes is usually much higher than normal.
You also may have imaging tests of the belly. These may include an ultrasound, a CT scan, or an MRI. A special MRI called MRCP can show images of the bile ducts. This test can be very helpful when gallstones are causing the problem.
Treatment of acute pancreatitis usually takes place in the hospital. It focuses on taking care of pain and supporting your body while your pancreas heals. In severe cases, treatment may occur in an intensive care unit to support breathing, treat serious infections, or help raise very low blood pressure.
If a gallstone is causing the problem, the gallstone may need to be removed. This is done during a procedure called ERCP. The doctor puts a scope in your mouth and moves it gently through the stomach and into the ducts from the pancreas and gallbladder. The doctor is then able to see a stone and remove it.
Sometimes the gallbladder, which makes gallstones, needs to be removed by surgery.
People with pancreatitis often need a lot of fluid to help support their other organs and their blood pressure. They get fluids through a vein (intravenous, or IV). Instead of food by mouth, nutrition is sometimes given through a vein while the pancreas heals.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
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Current as of: March 27, 2018
Kathleen Romito MD - Family Medicine & Adam Husney MD - Family Medicine & Peter J. Kahrilas MD - Gastroenterology
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