This overview is a sample of the type of information available to you at Griffin Hospital's Community Health Resource Center. It is not intended to replace your physician's instructions in the management of your health problems, but to better inform you about a particular illness and alert you to the availability of other materials. If you have a question about any piece of information presented in theses fact sheets, please call your physician, or stop by the Community Health Resource Center at your convenience.

PANCREATITIS

Pancreatitis is an inflammation of the pancreas, a gland in the upper abdomen near the stomach and the start of the small intestine.

In a healthy pancreas, digestive juices called enzymes are produced in the pancreas and deposited in the small intestine through a small, hollow tube (the common bile duct) which is also used by the liver and the gall bladder. Special cells within the pancreas make the hormone insulin, which helps the body process blood sugar.

Normally the digestive juices remain inactive until they are released into the small intestine. If they become activated while still in the pancreas, they begin to eat away at the gland, causing swelling, bleeding, and damage to veins. In other words, the juices that are supposed to digest food in the intestine start to digest the pancreas itself. The inflammation can lead to a blocked bile duct and can cause jaundice (a yellowing of the skin and eyes).

Acute pancreatitis comes on suddenly and can last from a day to a week. It sometimes causes cysts and abscesses to form. Digestive fluids also may leak into the abdominal cavity.

Chronic pancreatitis develops after many years of acute attacks. Sometimes it damages the pancreas permanently, so that the gland is unable to produce the substances needed for digestion and absorption of nutrients. Diabetes mellitus can also develop if the pancreas fails to produce adequate insulin.

WHAT CAUSES PANCREATITIS?

Most chronic cases of pancreatitis result from alcoholism. The condition also can develop from gall bladder or bile duct disease, viral infection, injury to the abdomen, poor nutrition, obesity, or the use of certain drugs. There may also be a genetic factor.

WHAT ARE THE SYMPTOMS?

Acute attacks of pancreatitis cause steady severe abdominal pain that may radiate to the back. The attacks often occur from 12 to 24 hours after a large meal or heavy drinking. Other symptoms include a low grade fever, weight loss, nausea, clammy skin, gas, and a tender, swollen abdomen.

In chronic pancreatitis, there is intermittent pain and frequently, weight loss. Stools may be pale in color and contain a large quantity of undigested fat. You may experience a yellowing of the skin and eyes (jaundice).

DIAGNOSING PANCREATITIS

Your doctor will ask about your medical history and do a physical examination to see if there is pain in your abdomen. He or she will also check your temperature, pulse, and bood pressure. Your blood and urine may be tested for levels of pancreatic enzymes, blood sugar, calcium and white blood cells. X-rays may be taken.

If chronic pancreatitis is suspected, a stool sample will be checked for fat content and additional blood tests will be performed. Your doctor may inject you with a substance that will stimulate the activity of your pancreas so he or she can measure its ability to secrete enzymes into the small intestine.

TREATMENT

If the doctor determines that you are suffering from pancreatitis, you will probably be hospitalized. It is important to discontinue the use of alcohol. In order to allow the pancreas to rest, you may be asked not to eat or drink anything. Food and fluids will be given to you intravenously (dripped directly into the veins). Excess stomach juices may be removed. You will be given pain relievers to help you with discomfort. If a cyst or abscess has formed, you may be treated with antibiotics. It is important to stay in bed and rest.

If the condition is caused by gallbladder disease or an obstructed bile duct, surgery may be performed to remove the gallstone or open the duct.

When you can eat, you will be given a bland, low-fat diet to reduce stress on the digestive system. You may receive an enzyme preparation with your meals to help digestion. Sometimes surgery is required to remove part of the pancreas.

WHAT YOU CAN DO

The most important step is to stop drinking alcohol. Alcoholics Anonymous is one of many programs and support systems available to assist you. Complete abstinence from drinking after the first acut attack may halt the progress of pancreatitis.

Heat applied to the abdomen often helps relieve pain. You may want to use a heating pad, hot water bottle, or hot compresses. It is important to follow the diet given to you and take digestive enzymes with your meals if your doctor prescribes them. Vitamin supplements may help you maintain a well balanced diet.

COPING

Acute, painful episodes of any illness can be frightening. A diagnosis of acute or chronic pancreatitis may require you to make difficult changes in your diet and lifestyle. You may feel temporarily depressed, guilty, or angry. If often helps to seek out others who are in a similar situation. Support groups exist for a wide variety of illnesses, and it may be helpful to get to know others who are going through the same thing.

Try to express your feelings to your family and friends, or seek professional counseling. Many programs, support groups and substance abuse counselors are available to help you. If you would like more information, ask you doctor or nurse.

Please note that this information is intended to give you a general overview of the topic. It is not intended to replace advice or instruction of a health professional. We recommend that you consult your physician, nurse, or qualified health professional regarding the information in this publication. © 1994 Planetree, Inc. Reproduction of this material in any form is limited to license agreement.

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