Acute Pancreatitis

Signs and Symptoms

Acute pancreatitis usually begins with a sharp, severe pain in the upper abdomen that may last for a few days. It may be constant pain that is just in the abdomen or it may reach to the back and other areas. The pain may be sudden and intense or it may begin as a mild pain that is aggravated by eating and slowly gets worse. In addition, the abdomen may be swollen and very tender. Other symptoms may include nausea, vomiting, fever and an elevated pulse.

Diagnosis

Your doctor will ask about your medical history, perform a physical exam and order a blood test that checks for certain enzymes. During acute attacks, the blood contains at least three times more than the normal amount of the digestive enzymes formed in the pancreas. Changes also may occur in blood levels of glucose, calcium, magnesium, sodium, potassium and bicarbonate. After the pancreas improves, these levels usually return to normal.

In addition, your doctor may recommend that you have an abdominal ultrasound to look for gallstones and a computerized tomography (CT) scan to check for injury to the pancreas.

Treatment

Treatment for acute pancreatitis depends on the severity of the attack. Acute pancreatitis usually gets better by itself, unless complications develop. Usually patients spend time in the hospital receiving intravenous fluids that help restore blood volume and hydration, as well as medications and certain enzymes to control pain.

Antibiotics may be given if signs of infection arise. Surgery may be needed if complications such as infection, cysts or bleeding occur. If gallstones were the cause of your attack, removal of the gallbladder or surgery of the bile duct may be required. A procedure known as endoscopic retrograde cholangiopancreatography (ERCP) also may relieve bile duct obstruction. During this procedure, a flexible tube is inserted down the throat into the stomach and small intestines. By injecting dye into the drainage tube of the pancreas, your doctor can see the area more clearly. Surgery to remove dead tissue on the pancreas also may be recommended.

Your doctor will likely give you dietary guidelines to follow in order to reduce the amount of fat you eat, since your body has trouble digesting these substances. You also may need to take pancreatic enzyme supplement tablets with meals. These supplements will help your body absorb food and help you regain some of the weight you lost during the attack.