Pancreatitis is an inflammation of the pancreas. The pancreas is an elongated gland that is hidden behind the stomach in the upper abdomen. The pancreas produces enzymes that promote digestion and hormones that regulate blood sugar levels. A distinction is made between acute pancreatitis and chronic pancreatitis. Acute pancreatitis occurs suddenly and causes a whole range of complaints.
- What is pancreatitis?
- Acute and chronic pancreatitis
- What are the functions of the pancreas?
- Causes of acute pancreatitis
- Symptoms of acute pancreatitis
- Examination and diagnosis
- Treatment of acute pancreatitis
- Healthy lifestyle
- Don’t drink alcohol
- Do not smoke
Pancreas or pancreas / Source: Decade3d/Shutterstock.com
What is pancreatitis?
Pancreatitis is an inflammation of the pancreas. The pancreas is a 12-15 cm elongated, cluster-shaped gland located behind the stomach, close to the duodenum – which forms the first part of the small intestine.
Acute and chronic pancreatitis
Pancreatitis can be acute or chronic. Both forms are serious and can lead to complications. Pancreatitis is more common in men than in women.
What are the functions of the pancreas?
The pancreas has two important functions:
- The production of pancreatic juice which contains digestive enzymes that, together with bile – a fluid produced in the liver and stored in the gallbladder – play an important role in the digestion of food.
- The pancreas contains glandular tissue – called the ‘Islets of Langerhans’ – that produces the hormones insulin and glucagon, among other things. The pancreas releases these hormones directly into the blood. These hormones play a role in regulating blood sugar levels.
Causes of acute pancreatitis
Acute pancreatitis is an inflammation of the pancreas that occurs suddenly and can lead to serious complications. The most common cause of acute pancreatitis is the presence of gallstones, which block the pancreatic duct. Excessive alcohol consumption is another common cause. Acute pancreatitis can also be caused by an accident, a blood circulation disorder, a metabolic disease, a viral infection, a tumor in the (nearby) pancreas, or certain medications. Sometimes the cause is not known. This is called ‘idiopathic pancreatitis’. Idiopathic literally means: ‘of unknown cause’.
Nausea / Source: Istock.com/CentralITAlliance
Symptoms of acute pancreatitis
Acute pancreatitis usually begins with a sudden onset of severe pain in the upper abdomen (center, right, rarely left), which can radiate to the back, left side and left shoulder and worsens with movement. Typical of this pain is the tendency to sit hunched over, placing the knees against the chest. The abdomen is swollen and painful when touched (pressure pain in the stomach area). Additional complaints include nausea, vomiting, fever, chills and accelerated breathing. The complaints may increase after a meal.
An ileus (intestinal blockage) can occur as a complication of pancreatitis. This can lead to shock, a life-threatening situation that requires immediate medical intervention. Jaundice (icterus) can occur if gallstones block the bile ducts, preventing bile from flowing out. When bleeding occurs in the pancreas, discoloration of the skin may occur in specific places: a subcutaneous bruising around the navel (‘Cullen’s sign’) and in the flank (‘Grey-Turner’s sign’).
Urinalysis / Source: Istock.com/jacky9946
Examination and diagnosis
The doctor will perform a thorough physical examination. A definitive diagnosis can be established on the basis of various tests, such as blood and urine tests and imaging diagnostics (an ultrasound of the upper abdomen). When acute pancreatitis is the result of gallstones blocking the duct of the gallbladder or pancreas, an ERCP (endoscopic retrograde cholangiopancreaticography) is performed, which can visualize the bile ducts. In this examination, a flexible tube – called an endoscope – is guided through the mouth and stomach to the duodenum. Various instruments can be inserted through the endoscope to remove the gallstones from the drainage duct.
Treatment of acute pancreatitis
A person with acute pancreatitis will most likely be hospitalized. The patient’s stomach must remain empty so that the pancreas is not stimulated to produce enzymes. The patient is not allowed to eat normal food and fluids are given through an IV. The gastric juice is sucked away through a tube in the nose that leads to the stomach.
If the condition is severe or if complications arise, treatment will follow in an intensive care unit. The treatment of acute pancreatitis is mainly aimed at preventing complications and removing the cause, such as gallstones. Sometimes it is necessary to surgically remove infected and affected pancreatic tissue. In some cases, the doctor may prescribe antibiotics or other medications.
Most patients have fully recovered after a period of one to two weeks. In approximately 10% of patients with acute pancreatitis, chronic pancreatitis develops.
You cannot 100% prevent pancreatitis from ever developing. However, there are measures you can take to reduce the chance of this happening, such as:
Maintain a healthy lifestyle or lose weight, if necessary. Keeping your body at a healthy weight will help your pancreas function better and reduce some of the risk factors that cause pancreatitis. These risk factors are gallstones, obesity and type 2 diabetes. Eat a healthy and varied diet and exercise regularly.
Don’t drink alcohol / Source: Marian Weyo/Shutterstock.com
Don’t drink alcohol
Heavy alcohol consumption is one of the main causes of both acute and chronic pancreatitis. The Nutrition Center’s advice is not to drink alcohol or at least not more than 1 glass per day. This advice is the same for men and women.
Do not smoke
Smoking is a risk factor for pancreatitis. The risk increases even more if you both smoke and drink alcohol. The risk of developing pancreatitis when smoking about a pack per day (15 to 24 grams of tobacco) was 2.6 times higher in both men and women than in non-smokers.
- Nutrition Center. Alcohol (beer, wine and spirits). https://www.voedingscentrum.nl/encyclopedie/alcohol.aspxNederland (accessed on 7-9-2022)
- Ned Tijdschr Geneeskd. 2009;153:C132
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