Pancreatitis: Symptoms, Diagnosis, Types, Causes & Treatment

Pancreatitis is characterized by inflammation of the pancreas that is caused by the progressive breakdown of pancreatic tissue by enzymes that the pancreas itself produced. It leads to symptoms such as abdominal pain, nausea, vomiting, fever and yellow skin and eyes.

Pancreatitis can be caused by excessive alcohol intake, gallstones, viral infections, autoimmune diseases or due to a medication side effect.

Pancreatitis is considered to be a medical emergency, and therefore, if you experience any of the above symptoms, you should proceed immediately to a hospital for assessment and treatment. Treatment usually involves medication, however some cases require surgical intervention.

Common symptoms

The main symptoms of pancreatitis are:

• Pain in the upper abdomen, which may radiate to the back, and worsen with time or after eating
• Nausea and vomiting
• Swelling and tenderness in the belly
• Yellow skin and eyes
• Fever
• Increased heart rate
• Yellow or white stools which may have white or oily streaks
• Unintentional weight loss
• Malnutrition, as food is not totally absorbed in the gut

It is important to consult a doctor if you notice these symptoms so that treatment can be started promptly. Quick treatment can prevent complications like bleeding, kidney disease, or abnormal heart or lung functioning, which can be life-threatening.

Confirming a diagnosis

Pancreatitis is diagnosed by a gastroenterologist or general practitioner, who will evaluate your symptoms, health history, medication use and alcohol intake before completing a physical assessment.

The doctor may also order imaging and lab tests, and will likely check amylase and lipase levels. These are enzymes that are produced by the pancreas and become elevated with pancreatitis.

Types of pancreatitis

The main types of pancreatitis are:

1. Acute pancreatitis

Acute pancreatitis occurs suddenly, with intense symptoms coming on abruptly. Many patients report abdominal pain, nausea and vomiting.

This type of pancreatitis has a relatively short duration, and is mainly caused by excessive alcohol intake, gallstones or medications.

2. Chronic pancreatitis

Chronic pancreatitis is characterized by symptoms that gradually worsen. It can potentially cause permanent damage to the pancreas and make treatment more complex.

This type of pancreatitis can be caused by alcohol abuse, but it can also be a complication of other health conditions, like cystic fibrosis and lupus, or occur  even after acute pancreatitis.

3. Alcoholic pancreatitis

Alcoholic pancreatitis is caused by excess alcohol intake and alcohol abuse. It is the most common cause of acute or chronic pancreatitis.

4. Autoimmune pancreatitis

Autoimmune pancreatitis is a rarer type of pancreatitis. With this type, the immune system produces antibodies that perceive the pancreas to be foreign tissue, which triggers them to attack and damage the pancreas.

This type of pancreatitis can result in chronic or recurrent pancreatitis.

Possible causes

The main causes of pancreatitis are:

• Excessive alcohol intake
• Gallstones
• High triglyceride levels
• High calcium levels 
• Pancreas injuries or tumors
• Use of medications, like azathioprine, mercaptopurine, valproic acid, ACE inhibitors or mesalamine
• Viral infections, like the mumps or measles
• Autoimmune conditions

Furthermore, people with a family history of pancreatitis are also more likely to develop this condition at some point in their lives.

Treatment options

Treatment for pancreatitis should be guided by a gastroenterologist or family doctor, and may vary depending on the type of pancreatitis you have.

The main treatment approaches for pancreatitis include:

1. Hospital admission

Hospitalization is indicated for acute pancreatitis, with administration of serum into the vein, fasting until the crisis passes or oral feeding if tolerated or through a nasogastric tube.

In addition, analgesic pain medications are used and antibiotics are used, in some cases, to reduce the risk of secondary infections.

2. Surgery

Surgery may be indicated to treat acute pancreatitis caused by gallbladder stones or gallbladder information.

Chronic pancreatitis may also require surgery if it presents with uncontrollable pain. The doctor may opt to remove the damaged part of the pancreas, or the entire organ.

3. Lifestyle changes

Patients with chronic pancreatitis are advised to incorporate lifestyle changes into their treatment plan, like smoking cessation or reducing/eliminating alcohol intake. A pancreatitis diet may also be beneficial for most patients. 

The doctor may also prescribe analgesics to help manage pain, as well as oral enzymes to promote optimal food digestion and nutrient absorption.

Other measures

Some precautions that can help to prevent new flare-ups of pancreatitis or speed-up recovery include:

• Taking medications as prescribed by your doctor and avoiding self-medication
• Avoiding alcohol 
• Increasing water intake;
• Avoiding fatty, fried or processed foods
• Smoking cessation
• Maintaining a healthy weight.

Furthermore, you are advised to eat small portions more frequently, and opting for light, easy-to-digest foods, such as white toast, crackers and rice.