What is Pancreatitis?
There are two types of pancreatitis: acute and chronic. The pancreas produces digestive enzymes and blood sugar regulating hormones, insulin and glucagon.
Acute pancreatitis is the sudden inflammation of the pancreas that is painful and at times deadly. Acute pancreatitis may be the first sign of gallstones. Gallstones can block the pancreatic duct, which can cause acute pancreatitis. Other causes may include medications, infections, trauma, metabolic disorders and surgery. In severe cases, acute pancreatitis can result in bleeding into the pancreas, serious tissue damage, infection and cyst formation. Severe pancreatitis can also harm other vital organs, such as the heart, lungs and kidneys and some cases of severe pancreatitis can result in death of pancreatitic tissue.
Chronic pancreatitis is the long-lasting inflammation of the pancreas. It most often occurs after an episode of acute pancreatitis. In roughly 70% of cases, chronic pancreatitis is caused by long-time alcohol consumption.
What are the Symptoms of Acute Pancreatitis?
Acute pancreatitis usually begins with gradual or sudden pain in the upper abdomen that sometimes extends to the back. The symptoms of acute pancreatitis may include:
- Upper abdominal pain that radiates into the back,
- Swollen and tender abdomen,
- Nausea and vomiting,
- Weight loss caused by poor absorption (malabsorption) of food
The abdominal pain, nausea and dehydration is usually self-limiting, but occasionally can progress to severe disease and even death. Severe acute pancreatitis can lead to life-threatening failure of multiple organs and infection. Hence, it is extremely important to seek medical attention if experiencing the signs and symptoms of acute pancreatitis. The mortality rate of acute pancreatitis is about 10%.
What are the Tests for Diagnosing Acute Pancreatitis?
Inflammation of the pancreas is known to cause high levels of amylase and lipase in the bloodstream. Amylase and lipase are digestive enzymes. Amylase helps your body break down starch, while lipase helps your body digest fats. The pancreas produces both of these enzymes.
To diagnose acute pancreatitis, pancreatic blood tests measure the levels in the blood of two digestive enzymes, amylase and lipase. High levels of these two enzymes suggest acute pancreatitis. A normal blood amylase is 23-85 units per liter (U/L) nad a normal lipase level is 0-160 units per liter. If the pancreas is damaged, these digestive enzymes can be found in the blood at higher levels than normal. Elevated amylase levels reveal a problem, but it may not necessarily involve the pancreas. Lipase levels, on the other hand, are usually specific for a pancreatic disorder.
Abnormal levels of amylase in the blood may be caused by acute pancreatitis, chronic pancreatitis, pancreatic cancer, cholecystitis (inflammation of the gallbladder) or a bile duct blockage. Pancreatic cancer may cause elevation in blood amylase and lipase due to impingement of the duct system within the pancreas.
Doctors may use other tests, including:
- Abdominal ultrasound, CT scan and MRI, which make images of the pancreas,
- ERCP (endoscopic retrograde cholangio-pancreatography) to look at the pancreatic and bile ducts using x-rays,
- Glucose intolerance test to measure damage to the cells in the pancreas that make insulin,
- Biopsy in which a small sample of pancreatic tissue is examined by a pathologist
What is the Treatment for Acute Pancreatitis?
Underlying causes need to be promptly evaluated. In most cases, acute pancreatitis resolves with therapy, but approximately 15% of patients develop severe infection. Most cases require hospitalization for 3-5 days for close monitoring, pain control and IV hydration.
Pancreatitis can be recurrent and requires a referral to a gastroenterologist.
Have Questions about Acute Pancreatitis?
If you have any questions about acute pancreatitis or pancreatic cancer, we will be happy to speak with you. You can call us at 845-802-0047.