Does pancreatitis pain come and go: Symptoms of Pancreatitis: Pain and Other Complications
Symptoms of Pancreatitis: Pain and Other Complications
Pancreatitis is associated with pain and a handful of other symptoms, some of which can be severe. There are two types of pancreatitis: acute and chronic.
Gallstones and alcohol are the two main causes of acute pancreatitis. With chronic pancreatitis, it’s been estimated that up to 55 percent of cases in the United States are due to heavy drinking or alcoholism. (1)
Where Is the Pain of Pancreatitis Felt?
The most common symptom of both acute and chronic pancreatitis is pain in the upper abdominal area, usually under the ribs. This pain:
- May be mild at first and get worse after eating or drinking
- May become constant, severe, and last for several days
- Tends to worsen while lying down on the back and lessen while leaning forward in a sitting position
- Often radiates throughout the back
- Is not aggravated by movement
- Is not dull or located in the lower abdominal area
The abdominal pain may also differ depending on the cause of the pancreatitis.
The pain of gallstone pancreatitis, for instance, is usually sudden, stabbing, and may radiate to the back.
The pain of alcoholic pancreatitis, on the other hand, may develop more slowly and be less localized.
Other Symptoms of Acute Pancreatitis
In addition to abdominal pain, nausea and vomiting are hallmark symptoms of acute pancreatitis. The stress on various systems can also cause those with the condition to appear as ill as they are. They may look pale, sweaty, and in distress.
Other symptoms include:
Because pancreatitis causes a drop in your digestive enzyme supply, you can’t sufficiently break down food. When you can’t sufficiently break down food, it isn’t absorbed as it needs to be, and this is what creates a change in the nature of stools. This difficulty absorbing food and its nutrients can lead to weight loss as well.
RELATED: Here’s What May Be Causing Your Digestive Gas Pain
Symptoms of Chronic Pancreatitis
Symptoms of chronic pancreatitis often manifest themselves only when complications arise or the condition worsens.
The pain of chronic pancreatitis takes two forms. In the first kind, the pain may come and go, flaring up for several hours or several weeks, with no discomfort in between flare-ups. In the second, the pain is steady and debilitating.
In some cases, those with this form of pancreatic may feel pain in parts of the body other than the abdomen. There may sometimes be no pain at all.
Some of the defining symptoms of chronic pancreatitis include:
- Weight loss
- Oily stools
What Is Severe Pancreatitis?
Acute pancreatitis is classified as mild, moderate, or severe.
Whereas mild or moderate pancreatitis lasts for days, severe pancreatitis can last for a number of weeks.
Severe pancreatitis, which occurs in 15 to 20 percent of acute pancreatitis cases, can lead to multiple complications. (2)
The first stage of severe pancreatitis is marked by organ failure that doesn’t subside on its own within 48 hours.
Scientists are still not sure exactly how this organ failure occurs, but they think that pancreatitis, being an inflammatory condition, sets off a chain reaction of inflammation that damages and compromises the systems related to or near the pancreas.
The lungs are affected first. Inflammation causes surrounding blood vessels to leak into the air sacs, and the fluid in the lungs makes it hard to breathe.
Respiratory problems caused by organ failure are the most frequent complications of acute pancreatitis. (3)
If organ failure is treated within a few days, the risk of dying is low. It’s been estimated that if the organ failure persists for a week or more, there is a 1 in 3 chance of dying. (4)
In severe pancreatitis, the tissues in the pancreas die — this is called pancreatic necrosis — and often become infected. This complication occurs after organ failure has been detected. To prevent the further spread of infection, the dead tissue is frequently removed.
It is possible to have severe pancreatitis with necrosis but without organ failure.
Other complications of severe pancreatitis include:
- Hemorrhaging (bleeding)
- Obstruction of the common bile duct
- Peritonitis, an inflammation of the tissue that lines the inner wall of the abdomen (the peritoneum)
- Rupturing of the pancreatic duct
- Acute respiratory distress syndrome (ARDS)
- Acute lung injury
RELATED: Exocrine Pancreatic Insufficiency: A Complication of Pancreatitis You Should Know About
What Are Other Complications Associated With Pancreatitis?
These are some of the other complications that may develop as a result of acute, severe, or chronic pancreatitis:
- Low blood pressure
- Breathing problems due to hormone changes that affect lung function
- Malnutrition due to the inefficient breakdown and absorption of food
- Pancreatic pseudocysts, or fluid and debris-filled sacs, which may cause bleeding and infection if they rupture
- Extra-pancreatic (outside of the pancreas) infections, including pneumonia, bloodstream infections, and urinary tract infections
Since your body is using its fluids to help fight the injuries to your pancreas, you may become dehydrated. Vomiting and the inability to eat may also contribute to dehydration, and it may also lead to low blood pressure.
How Is Pancreatitis Diagnosed?
As with most diseases, diagnosis of pancreatitis often begins with a medical history review and a physical examination.
Your doctor will also order a blood test and, possibly, one or more imaging tests, such as:
- Magnetic resonance imaging (MRI) scan, particularly magnetic resonance cholangiopancreatography, which visualizes the biliary and pancreatic ducts
- Computerized tomography (CT) scan
- Abdominal ultrasound
- Endoscopic ultrasound, which involves a long, thin tube that’s inserted into the small intestine through the throat
- Endoscopic retrograde cholangiopancreatography (ERCP), a procedure that uses an endoscope to help X-ray the bile and pancreatic ducts
- Magnetic resonance cholangiopancreatography (MRCP)
To be diagnosed with pancreatitis, you need to have at least two of the following symptoms:
- Abdominal pain associated with pancreatitis
- Blood test results showing you have levels of the pancreatic enzymes amylase or lipase that are at least three times the normal amount
- Abdominal images showing changes that are characteristic of pancreatitis
Additional reporting by Carlene Bauer.
Pancreatitis – Wake Gastroenterology
Pancreatitis is an inflammation of the pancreas. The pancreas is a large gland behind the stomach and close to the duodenum. The duodenum is the upper part of the small intestine. The pancreas secretes digestive enzymes into the small intestine through a tube called the pancreatic duct. These enzymes help digest fats, proteins, and carbohydrates in food. The pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormones help the body use the glucose it takes from food for energy.
Normally, digestive enzymes do not become active until they reach the small intestine,
where they begin digesting food. But if these enzymes become active inside the pancreas, they start “digesting” the pancreas itself.
Acute pancreatitis occurs suddenly and lasts for a short period of time and usually resolves. Chronic pancreatitis does not resolve itself and results in a slow destruction of the pancreas. Either form can cause serious complications. In severe cases, bleeding, tissue damage, and infection may occur. Pseudocysts – accumulations of fluid and tissue debris – may also develop. And enzymes and toxins may enter the bloodstream, injuring the heart, lungs, and kidneys, or other organs.
Some people have more than one attack and recover completely after each, but acute pancreatitis can be a severe, life-threatening illness with many complications. About 80,000 cases occur in the United States each year; some 20 percent of them are severe. Acute pancreatitis occurs more often in men than women.
Acute pancreatitis is usually caused by gallstones or by drinking too much alcohol, but these aren’t the only causes. If alcohol use and gallstones are ruled out, other possible causes of pancreatitis should be carefully examined so that appropriate treatment – if available – can begin.
Acute pancreatitis usually begins with pain in the upper abdomen that may last for a few days. The pain may be severe and may become constant – just in the abdomen – or it may reach to the back and other areas. It may be sudden and intense, or begin as a mild pain that gets worse when food is eaten. Someone with acute pancreatitis often looks and feels very sick. Other symptoms may include:
- swollen and tender abdomen
- rapid pulse
Severe cases may cause dehydration and low blood pressure. The heart, lungs, or kidneys may fail. If bleeding occurs in the pancreas, shock and sometimes even death follow.
Besides asking about a person’s medical history and doing a physical exam, a doctor will order a blood test to diagnose acute pancreatitis. During acute attacks, the blood contains at least three times more amylase and lipase than usual. Amylase and lipase are digestive enzymes formed in the pancreas. Changes may also occur in blood levels of glucose, calcium, magnesium, sodium, potassium, and bicarbonate. After the pancreas improves, these levels usually return to normal.
A doctor may also order an abdominal ultrasound to look for gallstones and a CT (computerized tomography) scan to look for inflammation or destruction of the pancreas. CT scans are also useful in locating pseudocysts.
Treatment depends on the severity of the attack. If no kidney or lung complications occur, acute pancreatitis usually improves on its own. Treatment, in general, is designed to support vital bodily functions and prevent complications. A hospital stay will be necessary so that fluids can be replaced intravenously.
If pancreatic pseudocysts occur and are considered large enough to interfere with the pancreas’s healing, your doctor may drain or surgically remove them.
Sometimes a person cannot stop vomiting and needs to have a tube placed in the stomach to remove fluid and air. In mild cases, a person may not eat for 3 or 4 days and instead may receive fluids and pain relievers through an IV (intravenous) line.
Unless the pancreatic duct or bile duct is blocked by gallstones, an acute attack usually lasts only a few days. In severe cases, a person may require intravenous feeding for 3 to 6 weeks while the pancreas slowly heals. This process is called total parenteral nutrition. However, for mild cases of the disease, total parenteral nutrition offers no benefit.
Before leaving the hospital, a person will be advised not to drink alcohol and not to eat large meals. After all signs of acute pancreatitis are gone, the doctor will try to decide what caused it in order to prevent future attacks. In some people, the cause of the attack is clear, but in others, more tests are needed.
Acute pancreatitis can cause breathing problems. Many people develop hypoxia, which means that cells and tissues are not receiving enough oxygen. Doctors treat hypoxia by giving oxygen through a face mask. Despite receiving oxygen, some people still experience lung failure and require a ventilator.
Sometimes a person cannot stop vomiting and needs to have a tube placed in the stomach to remove fluid and air. In mild cases, a person may not eat for 3 or 4 days and instead may receive fluids and pain relievers through an intravenous line.
If an infection develops, the doctor may prescribe antibiotics. Surgery may be needed for extensive infections. Surgery may also be necessary to find the source of bleeding, to rule out problems that resemble pancreatitis, or to remove severely damaged pancreatic tissue.
Acute pancreatitis can sometimes cause your kidneys to fail. If this happens, dialysis will be necessary to help your kidneys remove wastes from your blood.
Gallstones and Pancreatitis
Gallstones can cause pancreatitis and they usually require surgical removal. Ultrasound or a CT scan can detect gallstones and can sometimes give an idea of the severity of the pancreatitis. When gallstone surgery can be scheduled depends on how severe the pancreatitis is. If the pancreatitis is mild, gallstone surgery may proceed within about a week. More severe cases may mean gallstone surgery is delayed for a month or more.
After the gallstones are removed and inflammation goes away, the pancreas usually returns to normal. [Learn more about Gallstones.]
If injury to the pancreas continues, chronic pancreatitis may develop. Chronic pancreatitis occurs when digestive enzymes attack and destroy the pancreas and nearby tissues, causing scarring and pain. The usual cause of chronic pancreatitis is many years of alcohol abuse, but the chronic form may also be triggered by only one acute attack, especially if the pancreatic ducts are damaged. The damaged ducts cause the pancreas to become inflamed, tissue to be destroyed, and scar tissue to develop.
While common, alcoholism is not the only cause of chronic pancreatitis. The main causes of chronic pancreatitis are:
- blocked or narrowed pancreatic duct because of trauma or pseudocysts have formed
- unknown cause (idiopathic)
Damage from alcohol abuse may not appear for many years, and then a person may have a sudden attack of pancreatitis. In up to 70 percent of adult patients, chronic pancreatitis appears to be caused by alcoholism. This form is more common in men than in women and often develops between the ages of 30 and 40.
Hereditary pancreatitis usually begins in childhood, but it may not be diagnosed for several years. A person with hereditary pancreatitis usually has the typical symptoms that come and go over time. Episodes last from two days to two weeks.
Some cases of chronic pancreatitis are idiopathic, meaning that the cause is unknown.
Other causes of chronic pancreatitis are congenital conditions such as pancreas divisum, cystic fibrosis, high levels of calcium in the blood (hypercalcemia), high levels of blood fats (hyperlipidemia or hypertriglyceridemia), some drugs, and certain autoimmune conditions.
Most people with chronic pancreatitis have abdominal pain, although some people have no pain at all. The pain may get worse when eating or drinking, spread to the back, or become constant and disabling. In certain cases, abdominal pain goes away as the condition advances, probably because the pancreas is no longer making digestive enzymes. Other symptoms include nausea, vomiting, weight loss, and fatty stools.
People with chronic disease often lose weight, even when their appetite and eating habits are normal. The weight loss occurs because the body does not secrete enough pancreatic enzymes to break down food, so nutrients are not absorbed normally. Poor digestion leads to excretion of fat, protein, and sugar into the stool. If the insulin-producing cells of the pancreas (islet cells) have been damaged, diabetes may also develop at this stage.
Diagnosis may be difficult, but new techniques can help. Pancreatic function tests help a doctor decide whether the pancreas is still making enough digestive enzymes. Using ultrasonic imaging, endoscopic retrograde cholangiopancreatography (ERCP), and CT scans, a doctor can see problems indicating chronic pancreatitis. Such problems include calcification of the pancreas, in which tissue hardens from deposits of insoluble calcium salts. In more advanced stages of the disease, when diabetes and malabsorption occur, a doctor can use a number of blood, urine, and stool tests to help diagnose chronic pancreatitis and to monitor its progression.
Relieving pain is the first step in treating chronic pancreatitis. The next step is to plan a diet that is high in carbohydrates and low in fat.
A doctor may prescribe pancreatic enzymes to take with meals if the pancreas does not secrete enough of its own. The enzymes should be taken with every meal to help the body digest food and regain some weight. Sometimes insulin or other drugs are needed to control blood glucose.
In some cases, surgery is needed to relieve pain. The surgery may involve draining an enlarged pancreatic duct or removing part of the pancreas.
For fewer and milder attacks, people with pancreatitis must stop drinking alcohol, stick to their prescribed diet, and take the proper medications.
Points to Remember
- Pancreatitis begins when the digestive enzymes become active inside the pancreas and start “digesting” it.
- Pancreatitis has two forms: acute and chronic.
- Common causes of pancreatitis are gallstones or alcohol abuse.
- Sometimes no cause for pancreatitis can be found.
- Symptoms of acute pancreatitis include pain in the abdomen, nausea, vomiting, fever, and a rapid pulse.
- Treatment for acute pancreatitis can include intravenous fluids, oxygen, antibiotics, or surgery.
- Acute pancreatitis becomes chronic when pancreatic tissue is destroyed and scarring develops.
For More Information
For more information on this topic, visit:
American Gastroenterological Association
Pancreatitis | Gastroenterology San Antonio
Digestive enzymes from the pancreas normally do not become active before reaching the small intestine. However, if the pancreas is inflamed, the enzymes can activate within the pancreas and cause tissue damage.
Treatment may not be necessary for mild pancreatitis, but severe pancreatitis can cause life-threatening complications.
Acute and Chronic Pancreatitis
Acute pancreatitis is when the condition appears suddenly and lasts for days. Depending on the severity, acute pancreatitis can be life-threatening. Gallstones and heavy alcohol use are common causes. Acute pancreatitis may occur within hours or as long as two days after consuming alcohol.
Chronic pancreatitis is when the condition occurs over several years, and does not heal or improve. It develops most often in people between the ages of 30 and 40 and is often linked to years of heavy alcohol use.
Chronic pancreatitis can be triggered by a single acute attack that causes damage to the pancreatic duct. That damage causes inflammation and scar tissue, which slowly destroys the pancreas.
The signs of pancreatitis may vary between acute and chronic cases.
Acute pancreatitis symptoms
- Pain in the upper abdomen
- Abdominal pain that radiates to your back
- Swollen or tender abdomen
- Nausea / Vomiting
- Rapid pulse
Chronic pancreatitis symptoms include:
- Pain in the upper abdomen
- Weight loss (unintentional)
- Nausea / Vomiting
- Oily stools
Schedule an appointment if you have persistent abdominal pain. If you have severe abdominal pain, seek immediate care.
Acute Pancreatitis Causes
The most common acute pancreatitis cause is gallstones. Gallstones are stone-like formations that develop in the gallbladder. As gallstones pass through the common bile duct, it can cause inflammation of the pancreas. Heavy alcohol use is also common. Possible acute pancreatitis causes include:
- Heavy alcohol use
- Trauma to the abdomen
- Genetic abnormalities
Chronic Pancreatitis Causes
- Hereditary disorders of the pancreas
- Cystic fibrosis (the most common inherited disorder)
- Hypercalcemia (high levels of calcium in the blood)
- Hyperlipidemia or hypertriglyceridemia (high levels of blood fats)
- Certain medications
- Certain autoimmune conditions
- Long-term alcohol use
- Unknown causes
Hereditary pancreatitis may be present in someone under 30 years old but may go undiagnosed for several years. Brief periods of abdominal pain and diarrhea may come and go and eventually lead to chronic pancreatitis.
Hereditary pancreatitis is more common for people who have two or more family members that have pancreatitis across more than one generation.
Doctors will review a person’s medical history, perform a physical examination, and order blood tests to diagnose pancreatitis. During cases of acute pancreatitis, the blood will have high levels of the digestive enzymes formed in the pancreas.
Procedures and tests used to diagnose pancreatitis include:
- Blood tests – These tests look for elevated levels of pancreatic enzymes.
- Urine or Stool Tests (for chronic pancreatitis)
- CT Scan – A type of x-ray that can create 3-D images of internal organs.
- Ultrasound – Another type of imaging that uses sound waves to visualize internal organs. Doctors look for inflammation in the bile or pancreatic duct.
- Endoscopic Ultrasound (EUS) – A combination of technology, using an endoscope and ultrasound. The endoscope is a thin, lighted tube that is inserted through the mouth and down into the digestive tract. The endoscope is fitted with an ultrasound attachment that produces images of the bile and pancreatic ducts.
- MRI – Magnetic resonance imaging can also be used to look for abnormalities in the gallbladder, pancreas, and ducts.
Treatment for pancreatitis may involve hospitalization. Treatments may include:
- Fasting – To allow your pancreas time to rest, fasting (not eating) may be recommended for several days. This allows your pancreas to recover and a reduction in inflammation.Clear liquids and bland foods can be reintroduced once the inflammation is controlled. Eventually, patients can resume a normal diet. If inflammation persists, a feeding tube may be recommended for proper nutrition.
- Medications for Pain – Severe pain is common with pancreatitis. There are medications that can help.
- IV Fluids – Intravenous fluids will be provided during a hospital stay to ensure proper hydration and nutrient levels.
The underlying cause of pancreatitis will be treated separately once inflammation is under control.
Treatment will depend on the underlying cause, and may include:
- Removing obstructions in the bile duct – If pancreatitis is caused by a blocked or narrowed bile duct, it could require a procedure to restore normal function.
- Endoscopic Retrograde Cholangiopancreatography (ERCP) is a procedure that uses a thin tube with a small camera to examine the bile ducts and pancreas. This procedure can help diagnose problems. It also carries a slight risk of complications including severe pancreatitis, bowel perforation, infection, or bleeding. Some procedures are performed using ERCP include
- Sphincterotomy – In this procedure, a tiny incision is made in the muscle surrounding the pancreatic or bile duct using a small wire on the endoscope. This helps enlarge the duct opening.
- Gallstone removal – If gallstones are present, a small basket on the endoscope may be used to retrieve pancreatic or bile duct stones.
- Stent placement – A small piece of plastic or metal resembling a small straw can be inserted into the bile or pancreatic duct to keep it open.
- Balloon dilation – Some endoscopes have can inflate a small balloon that dilates (stretches) the bile or pancreatic duct. A stent may be used temporarily.
- Gallbladder surgery – If pancreatitis is caused by gallstones, surgery to remove your gallbladder (cholecystectomy) may be recommended.
- Pancreas surgery – If fluid needs to be drained from the pancreas, or diseased tissue needs to be removed, it may require surgery.
- Alcohol treatment – If alcohol dependence is the cause of pancreatitis, your doctor may recommend treatment for alcohol addiction. Drinking could worsen pancreatitis and cause serious complications.
- Synthetic pancreatic enzymes – If the pancreas doesn’t make enough enzymes on its own, the doctor may prescribe additional enzymes to be consumed with food.
- Dietary changes – a nutritious, low-fat diet is important for people with pancreatitis. A registered dietitian can help develop a meal plan. Drinking plenty of fluids, avoiding caffeine, and eating more numerous, smaller meals instead of fewer large ones will also help manage pancreatitis.
Complications of Pancreatitis
Pancreatitis can cause some complications, including:
- Pseudocysts – cyst-like pockets in the pancreas that collect fluid and debris. If a pseudocyst ruptures, it could cause further complications like infection and internal bleeding.
- Infection – Pancreatitis can make the pancreas vulnerable to infection.
Kidney failure – Dialysis may be necessary to treat kidney failure caused by pancreatitis.
- Breathing problems – In rare cases, pancreatitis can cause breathing problems by not allowing enough oxygen in your blood.
- Malnutrition – Pancreatitis can cause lower levels the enzymes needed to break down food and process nutrients. This can cause malnutrition, weight loss, and diarrhea.
- Diabetes – If the insulin-producing cells of the pancreas are damaged through pancreatitis, diabetes may develop.
- Pancreatic cancer – The inflammation from chronic pancreatitis increases the risk of developing pancreatic cancer.
Where is the pancreas?
The pancreas is located in the upper abdomen near the stomach and first part of the small intestine (duodenum).
What is the most common cause of pancreatitis?
Some of the most common causes of pancreatitis include gallstones and heavy alcohol use.
How dangerous is pancreatitis?
Pancreatitis can be dangerous if it goes undiagnosed and untreated. If you have the signs or symptoms of pancreatitis, you should seek medical attention.
How can I treat pancreatitis at home?
Pancreatitis cannot be treated at home, but once you leave the hospital and return home, you can aid the healing process by following these recommendations:
- Stop drinking alcohol
- Stop smoking
- Eat a low-fat diet
- Stay hydrated (drink more fluids)
1. Produce enzymes that help digestion
2. Produce hormones, like insulin and glucagon, that help regulate the sugar (glucose) in the bloodstream.
Digestive enzymes from the pancreas normally do not become active before reaching the small intestine. However, if the pancreas is inflamed, the enzymes can activate within the pancreas and cause tissue damage.
Treatment may not be necessary for mild pancreatitis, but severe pancreatitis can cause life-threatening complications.”,
“name”: “Heavy alcohol use”
“name”: “Trauma to the abdomen”
“name”: “Genetic abnormalities”
“name”: “Hereditary disorders of the pancreas”
“name”: “Cystic fibrosis (the most common inherited disorder)”
“name”: “Hypercalcemia (high levels of calcium in the blood)”
“name”: “Certain medications”
“name”: “Certain autoimmune conditions”
“name”: “Long-term alcohol use”
“name”: “Unknown causes”
“name”: “Treatment for pancreatitis may involve hospitalization. ”
“name”: “Fasting – To allow your pancreas time to rest, fasting (not eating) may be recommended for several days. This allows your pancreas to recover and a reduction in inflammation.
Clear liquids and bland foods can be reintroduced once the inflammation is controlled. Eventually, patients can resume a normal diet. If inflammation persists, a feeding tube may be recommended for proper nutrition.”
“name”: “Medications for Pain – Severe pain is common with pancreatitis. There are medications that can help.”
“name”: “IV Fluids – Intravenous fluids will be provided during a hospital stay to ensure proper hydration and nutrient levels.”
“name”: “Removing obstructions in the bile duct – If pancreatitis is caused by a blocked or narrowed bile duct, it could require a procedure to restore normal function.”
“name”: “Endoscopic Retrograde Cholangiopancreatography (ERCP) is a procedure that uses a thin tube with a small camera to examine the bile ducts and pancreas. This procedure can help diagnose problems”
“name”: “Gallbladder surgery – If pancreatitis is caused by gallstones, surgery to remove your gallbladder (cholecystectomy) may be recommended.”
“name”: “Pancreas surgery – If fluid needs to be drained from the pancreas, or diseased tissue needs to be removed, it may require surgery.”
“name”: “Alcohol treatment – If alcohol dependence is the cause of pancreatitis, your doctor may recommend treatment for alcohol addiction. Drinking could worsen pancreatitis and cause serious complications.”
“name”: “Synthetic pancreatic enzymes – If the pancreas doesn’t make enough enzymes on its own, the doctor may prescribe additional enzymes to be consumed with food.”
“name”: “Dietary changes – a nutritious, low-fat diet is important for people with pancreatitis. A registered dietitian can help develop a meal plan.Drinking plenty of fluids, avoiding caffeine, and eating more numerous, smaller meals instead of fewer large ones will also help manage pancreatitis.”
“name”: “Pain in the upper abdomen”
“name”: “Abdominal pain that radiates to your back”
“name”: “Swollen or tender abdomen”
“name”: “Nausea / Vomiting”
“name”: “Rapid pulse”
“name”: “Weight loss (unintentional)”
“name”: “Oily stools”
Chronic Pancreatitis | MUSC Health
What is chronic pancreatitis?
Chronic pancreatitis is different from acute pancreatitis in that the inflammation and damage develop more slowly, and can become increasingly bad over time. The pancreas becomes scarred and loses its ability to make enough digestive enzymes and insulin. Thickening of the pancreatic juices may result in clogging of the pancreatic ducts and pancreatic stones which, along with damage to the ducts themselves can result in aggravation of the pancreatitis due to obstruction.
When chronic pancreatitis occurs in many members of the family, sometimes starting with childhood attacks, it is called familial pancreatitis. A similar form of chronic pancreatitis occurs in tropical countries, often associated with severe malnutrition.
Presentation and clinical features
Most patients with chronic pancreatitis have pain in the upper abdomen, which may also be felt in the back. This can be very severe and continuous, but is more often intermittent, and occurs in attacks, which are usually not sufficiently severe to require immediate treatment in hospital. A few patients with chronic pancreatitis never have pain.
Lack of enzymes due to pancreatic damage results in poor digestion and absorption of food, especially fats. Thus, weight loss is characteristic of chronic pancreatitis. Patients may notice bulky smelly bowel movements due to too much fat (steatorrhea). Occasionally, an “oil slick” can be seen on the toilet water.
Swelling and scarring of the pancreas may damage other local structures. If the bile duct is narrowed, the patient may develop jaundice. Inflammation of the large vein (splenic vein) behind the pancreas may cause increased pressure in veins elsewhere, and the development of varices in the upper stomach and lower esophagus; these can burst and cause severe bleeding.
Patients with chronic pancreatitis carry a slightly increased risk of developing pancreatic cancer.
Recognition and workup
The diagnosis of chronic pancreatitis is obvious in an advanced case with typical features: upper abdominal pains with weight loss; steatorrhea; and, diabetes. However, all of these features are seen only when the disease has been present for many years.
Most patients present with pain only. Similar pains can be caused by cancer of the pancreas (although this is not usually intermittent), gallstones and bile duct stones, or severe types of gastric or duodenal ulcers. All of these conditions have to be considered and appropriate diagnostic tests applied.
Endoscopic ultrasound is a technique used to detect subtle and early changes of chronic pancreatitis while ERCP is widely used in the evaluation and management of patients with known or suspected chronic pancreatitis. Chronic pancreatitis can be confirmed by X-ray tests, ultrasonography, CT scans, and MRCP.
Patients with chronic pancreatitis are treated by:
- abstaining from alcohol;
- medicines for pain relief;
- nutritional support; and,
- replacement (by mouth) of missing digestive enzymes.
Patients are normally advised to maintain a diet low in fat (less than 40 gm per day) when steatorrhea is present. Pancreatic enzyme supplements need to be taken in high dosage and with meals (often with medicines to reduce gastric acid). These help to digest fat, and may also sometimes reduce the amount of pain.
Pain control can be a challenge in patients with severe longstanding chronic pancreatitis. Narcotic addiction is a risk. It is possible to block the nerves which come from the pancreas by injection treatments (celiac plexus block). However, the effect rarely lasts more than a few months.
Surgical treatment may be helpful in certain circumstances, particularly to relieve obstruction to the pancreatic duct or bile duct, or to remove damaged or poorly drained pancreatic tissue. The most common operations are the Puestow and Whipple procedures, or a distal pancreatectomy. (Rarely would it be required to remove the entire pancreas.) Some patients with chronic pancreatitis have pseudocysts, which sometimes requires surgical drainage.
ERCP techniques have limited application in the treatment of patients with chronic pancreatitis, although sometimes ERCP is helpful to improve pancreatic drainage via the removal of stones or placement of stents. This can help also when there is leakage of pancreatic fluids (pancreatic fistulas).
Fistulas means leakage of fluid from an internal organ to the skin. This happens when the juices cannot drain through the normal routes. In the case of pancreatic fistulas, this happens when the pancreatic duct is blocked, particularly after an injury to the pancreas or surgery to it.
Although many fistulas dry up spontaneously after a few weeks, the process can be sped up by injections of a drug that reduces the production of pancreatic juices. In many cases it will be necessary to unblock the pancreas by surgical method or by various methods of ERCP.
Chronic Pancreatitis | Cedars-Sinai
Not what you’re looking for?
What is chronic pancreatitis?
pancreas is an organ with many important functions. It makes enzymes that help you
digest food. It also makes insulin to keep your blood sugar levels under control.
Short-term (acute) pancreatitis is a sudden inflammation of your pancreas. This can
very painful. You may have nausea, vomiting, and fever. If your acute pancreatitis
doesn’t get better and slowly gets worse, you may have chronic pancreatitis.
What causes chronic pancreatitis?
you have chronic pancreatitis, the digestive enzymes that would normally travel by
inside your pancreas and empty into your upper intestine, become trapped inside your
pancreas. This causes pain and scarring. The trapped enzymes slowly cause severe
to your pancreas.
most common cause of chronic pancreatitis is drinking a lot of alcohol over a long
period of time.. Other causes include:
- An attack of acute pancreatitis that damages your pancreatic ducts
- A blockage of the main pancreatic duct caused by cancer
- Certain autoimmune disorders
- Hereditary diseases of the pancreas
cause in some cases
What are the symptoms of chronic pancreatitis?
Early symptoms of chronic pancreatitis are similar to acute pancreatitis. Symptoms
occasional and include:
- Pain in
the upper belly that spreads into the back
- Pain in
the belly that gets worse when you eat or drink alcohol
- Diarrhea or oily stools
- Nausea and vomiting
belly (abdominal) pain that may be constant or that comes back
- Weight loss
Chronic pancreatitis causes severe damage to your pancreas. This means that your
won’t be able to make needed enzymes and hormones. This can result in malnutrition,
because you won’t be able to digest foods. Chronic pancreatitis can also cause diabetes.
This happens because your pancreas can’t make insulin. Insulin controls blood sugar.
How is chronic pancreatitis diagnosed?
Your healthcare provider will diagnose you with chronic pancreatitis if:
- You have a history of acute pancreatitis that comes back or doesn’t get better
- You have symptoms of chronic pancreatitis
healthcare provider will examine your belly. You will also be asked about your drinking
history and any family history of pancreatic disease or cystic fibrosis. Blood and
imaging tests are an important part of your diagnosis. They can include:
They will look for high levels of two pancreatic enzymes, amylase and
lipase. These may spill into your blood. Other tests may show blockage or damage of
your gallbladder. They can also be used to check for certain inherited conditions.
You may need vitamin levels and other lab tests.
- Abdominal ultrasound. This test uses sound waves to create an image of your pancreas.
This test uses a long, thin tube (endoscope) that is put through
your mouth and into your stomach and upper intestine. An ultrasound on the scope
makes images of the pancreas and gallbladder ducts.
ERCP. This test uses a long, thin tube (endoscope) that is
put into the pancreas drainage area if treatment needs to be done.
This test makes images using radio
waves, a strong magnet, and a computer. In some MRI tests, you will need to have dye
injected to show a more detailed image of your pancreas and the ducts of your
How is chronic pancreatitis treated?
Day-to-day treatment includes:
- Pain medicine
- Pancreatic enzyme supplements with every meal
- Insulin, if you develop diabetes
supplements, if needed
acute pancreatitis or a flare-up, you may need to stay in the hospital for treatment.
Your exact treatment will depend on the cause of your chronic pancreatitis, how severe
the symptoms are, and your physical condition. Acute treatments may include:
- Feeding through a tube through the nose into the stomach
What are possible complications of
Chronic pancreatitis damages the insulin-producing cells of the pancreas. This may
cause these complications:
- Calcification of the pancreas. This means the pancreatic tissue hardens from
deposits of calcium salts.
- Long-term (chronic) pain
- Kidney failure
of fluid and tissue debris (pseudocysts)
- Pancreatic cancer
flare-ups that keep coming back
How can I help prevent chronic
best way to prevent chronic pancreatitis is to drink only in moderation or not at
Moderate alcohol drinking is considered to be no more than 1 drink per day for women
2 drinks per day for men. Quitting smoking is also very helpful. It eases pain and
Living with chronic pancreatitis
If you have been diagnosed with chronic pancreatitis, your healthcare provider may
suggest these lifestyle changes:
- Don’t drink alcoholic drinks.
- Drink plenty of water.
- Don’t smoke.
clear of caffeine.
- Stick to a healthy diet that’s low in fat and protein.
- Eat smaller and more frequent meals.
When should I call my healthcare
your healthcare provider when you start to have short-term (acute) symptoms, including:
- Severe pain that can’t be eased at home
- Vomiting and are unable to keep down fluids
Key points about chronic
- Acute pancreatitis is a sudden inflammation of your pancreas. If
your acute pancreatitis doesn’t get better and slowly gets worse, you have chronic
- If you have chronic pancreatitis, the digestive enzymes that
would normally travel by tubes inside your pancreas and empty into your upper
intestine, become trapped inside your pancreas.
- Your healthcare provider will examine your belly. You will be
asked about your drinking history and any family history of pancreatic disease or
Day-to-day treatment includes
pain medicine, pancreatic enzyme supplements with every meal, insulin if you
develop diabetes, and vitamin supplements if needed.
- If you have been diagnosed with chronic pancreatitis, your
healthcare provider may suggest lifestyle changes.
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your healthcare
provider tells you.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your healthcare provider gives you.
why a new medicine or treatment is prescribed, and how it will help you. Also know
what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that
- Know how you can contact your healthcare provider if you have questions.
Medical Reviewer: Jen Lehrer MD
Medical Reviewer: Rita Sather RN
Medical Reviewer: Raymond Kent Turley BSN MSN RN
© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.
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10 Pancreatic Cancer Symptoms & Signs Not To Ignore
Pancreatic cancer often goes undetected until it’s advanced and difficult to treat. In the vast majority of cases, symptoms only develop after pancreatic cancer has grown and begun to spread.
Because more than 95% of pancreatic cancer is the exocrine type, we’ll describe those symptoms first, followed by symptoms of rare forms of pancreatic cancer.
Pancreatic Cancer Symptoms: Location Matters
Initially, pancreatic cancer tends to be silent and painless as it grows. By the time it’s large enough to cause symptoms, pancreatic cancer has generally grown outside the pancreas. Because of the location of the pancreas in the body, symptoms include:
- Jaundice. As pancreatic cancer blocks duct that releases bile into the intestine (common bile duct), the ingredients of bile build up in the blood. This turns the skin and the eyes yellow, a condition called jaundice. The same blockage causes dark urine, light colored stools, and itching.
- Abdominal pain. Pancreatic cancer can cause a dull ache in the upper abdomen radiating to the back. The pain may come and go.
- Back pain.
- Bloating. Some people with pancreatic cancer have a sense of early fullness with meals (satiety) or an uncomfortable swelling in the abdomen.
In general, symptoms appear earlier from cancers in the head of the pancreas, compared to those in the body and tail. Keep in mind that having any or all of these symptoms doesn’t mean a person has pancreatic cancer. There are many other causes for these types of symptoms.
Pancreatic Cancer: Whole-Body Symptoms
As it grows and spreads, pancreatic cancer affects the whole body. Such symptoms can include:
- Weight loss
- Loss of appetite
- Elevated blood sugars. Some people with pancreatic cancer develop diabetes as the cancer impairs the pancreas’ ability to produce insulin. (However, the vast majority of people with a new diagnosis of diabetes do not have pancreatic cancer.)
Symptoms of Rare Pancreatic Cancers
Islet cell tumors, also called neuroendocrine tumors, arise from the cells in the pancreas that make hormones. Islet cell tumors account for less than 5% of all pancreas tumors.
Like pancreatic adenocarcinoma, islet cell tumors may cause abdominal pain, weight loss, nausea, and vomiting. Hormones released by an islet cell tumor can also cause symptoms: These include
- Insulinomas (excess insulin): sweating, anxiety, lightheadedness, and fainting from low blood sugar
- Glucagonomas (excess glucagon): diarrhea, excessive thirst or urination, weight loss
- Gastrinomas (excess gastrin): abdominal pain, stomach ulcers that can bleed, reflux, weight loss
- Somatostatinomas (excess somatostatin): diarrhea, weight loss, abdominal pain, foul-smelling fatty stools
- VIPomas (excess vasoactive intestinal peptide): watery diarrhea, abdominal cramping, facial flushing
Pancreatic Cancer’s Sneaky Symptoms
In a very small number of people with pancreatic cancer, early symptoms might be present that could lead to an earlier diagnosis. Unfortunately, researchers have been unable to identify any predictable pattern.
The rarity and vagueness of these situations point out the difficulty of using early symptoms to catch pancreatic cancer.
That said, symptoms like unintentional weight loss, persistent loss of appetite, yellowing of the eyes or skin, dark urine, or light-colored stools should always prompt concern. Persistent or worsening discomfort, nausea, vomiting, or diarrhea are also disconcerting. If you feel something’s not right, see your doctor.
Chronic pancreatitis – NHS
Chronic pancreatitis is a condition where the pancreas has become permanently damaged from inflammation and stops working properly.
The pancreas is a small organ, located behind the stomach, that helps with digestion.
Chronic pancreatitis can affect people of any age, but it usually develops between the ages of 30 and 40 as a result of heavy drinking over many years. It’s more common in men.
It’s different from acute pancreatitis, where the inflammation is only short term.
Most people with chronic pancreatitis have had 1 or more attacks of acute pancreatitis.
Symptoms of chronic pancreatitis
The most common symptom of chronic pancreatitis is repeated episodes of severe pain in your tummy (abdomen).
The pain usually develops in the middle or left side of your tummy and can move along your back.
It’s been described as a burning or shooting pain that comes and goes, but may last for several hours or days.
Although the pain sometimes comes on after eating a meal, there’s often no trigger. Some people might feel sick and vomit.
As the condition progresses, the painful episodes may become more frequent and severe.
Eventually, a constant dull pain can develop in your tummy, between episodes of severe pain.
This is most common in people who continue to drink alcohol after being diagnosed with chronic pancreatitis.
Some people who stop drinking alcohol and stop smoking may find the pain is less severe.
Advanced chronic pancreatitis
Other symptoms develop as the damage to the pancreas progresses and it becomes unable to produce digestive juices, which help to break down food.
The absence of digestive juices means it’s harder to break down fats and some proteins. This can cause your poo to become very smelly and greasy, and make it difficult to flush down the toilet.
The pancreas usually only loses these functions many years after the first symptoms started.
You may also experience:
When to get medical advice
See a GP immediately if you’re experiencing severe pain, as this is a warning sign that something is wrong.
If this is not possible, call NHS 111 for advice.
You should also see a GP as soon as you can if you:
- develop symptoms of jaundice
- keep being sick
Jaundice can have a range of causes other than pancreatitis, but it’s usually a sign there’s something wrong with your digestive system.
Diagnosing chronic pancreatitis
A GP will ask about your symptoms and may examine you.
They’ll refer you to a specialist for further tests if they think you have chronic pancreatitis.
The specialist will be able to confirm whether you have the condition.
Tests and scans are usually carried out in your local hospital.
They may include:
- an ultrasound scan – where sound waves are used to create a picture of your pancreas
- a CT scan – where a series of X-rays are taken to build up a more detailed 3D image of your pancreas
- an endoscopic ultrasound scan – where a long, thin tube containing a camera is passed through your mouth and down into your stomach to take pictures of your pancreas
- magnetic resonance cholangiopancreatography (MRCP) – a type of MRI scan that takes a detailed image of your pancreas and the organs around it
Sometimes the symptoms of chronic pancreatitis can be very similar to pancreatic cancer.
You may need a biopsy, where a small sample of cells is taken from the pancreas and sent to a laboratory to be checked, to rule this out.
Causes of chronic pancreatitis
The most common cause of chronic pancreatitis is drinking excessive amounts of alcohol over many years.
This can cause repeated episodes of acute pancreatitis, which results in increasing damage to the organ.
Find out more about alcohol misuse
In children the most common cause is cystic fibrosis.
Less common causes include:
- the immune system attacking the pancreas (autoimmune chronic pancreatitis)
- inheriting a faulty gene that stops the pancreas working properly
- injury to the pancreas
- gallstones blocking the openings (ducts) of the pancreas
- radiotherapy to the tummy
In some cases, no cause can be identified. This is called idiopathic chronic pancreatitis.
Treatment for chronic pancreatitis
The damage to the pancreas is permanent, but treatment can help control the condition and manage any symptoms.
People with chronic pancreatitis are usually advised to make lifestyle changes, such as stopping drinking alcohol and stopping smoking. They’re also given medicine to relieve pain.
Surgery may also be an option for those experiencing severe pain.
Living with chronic pain can cause mental as well as physical strain.
See a GP if you’re experiencing stress, anxiety or depression caused by chronic pancreatitis.
About 1 in 3 people with chronic pancreatitis will eventually develop a type of diabetes known as type 3c diabetes.
This occurs when the pancreas can no longer produce insulin because it’s become so damaged.
People with chronic pancreatitis can sometimes develop sacs of fluid on the surface of their pancreas (pseudocysts). These can cause bloating, indigestion and dull tummy pain.
These cysts often disappear on their own. But sometimes they need to be drained using a technique called endoscopic ultrasound drainage, or endoscopic transpapillary drainage.
Chronic pancreatitis increases your risk of pancreatic cancer, although the chance is still small.
Support for people living with chronic pancreatitis
Any long-term health condition, particularly one that causes recurring episodes of pain or constant pain, can affect your emotional and psychological health.
See a GP if you’re experiencing psychological and emotional difficulties. There are medicines available that can help with stress, anxiety and depression.
Talking to other people with the same condition can often reduce feelings of isolation and stress.
The charity Guts UK, may be able to put you in touch with a local support group.
Page last reviewed: 31 October 2018
Next review due: 31 October 2021
90,000 symptoms and treatment of pain in pancreatitis in Izhevsk
The onset of pain in pancreatitis is one of the main symptoms of the inflammatory process in the pancreas. The cause of inflammation can be a violation of the integrity of the gland or blockage of the excretory ducts, which inevitably leads to destructive changes in the tissues of the organ.
If you are suffering from pancreatic pain, you should not self-medicate, but it is better to immediately contact the gastroenterologists of the clinic of Dr. Elena Malysheva.You will be provided with fast and, most importantly, professional assistance!
Doctors will quickly relieve pain, conduct a thorough examination and, taking into account the diagnosis, select an individual therapy.
Nature of pain
Pain sensations differ in degree of strength depending on the stage of the disease, the degree of changes in the gland and nearby organs. Acute pancreatitis is accompanied by sharp and severe pain that occurs immediately after eating – it is localized in the upper abdomen and can shift to the right or left hypochondrium.In rare cases, the pain symptom may resemble attacks of angina pectoris, take on a shingles and intensify after taking prohibited foods.
In chronic pancreatitis, the pain is not so strong, it occurs periodically, usually after eating fatty, spicy and fried foods, alcoholic beverages. Sometimes dull and aching pains torment the patient after overeating at night. The pancreas does not produce enough enzymes to fully digest food, resulting in a spasm that captures both the stomach and the gland itself.
If pancreatitis is accompanied by duodenal ulcer, the nature of the pain changes – it becomes burning, cutting, localized in the abdomen and appears in the morning. Pain often occurs on an empty stomach.
Occurrence of recurrent or persistent pain in pancreatitis is a reason for immediate medical attention. The examination of the patient begins with an examination and diagnostic examination, which may include:
- Ultrasound of the abdominal cavity;
If the doctor suspects a concomitant disorder of the digestive system with pancreatitis, additional studies are prescribed: scatological analysis of feces, blood biochemistry, blood sugar and pancreatic enzymes.
Treatment of pain in pancreatitis
Considering that pain in pancreatitis is a symptom of pancreatic inflammation, an experienced gastroenterologist should deal with the treatment of the disease. If the attack is acute, you need to immediately consult a doctor so that he accurately diagnoses and relieves the pain symptom.At the same time, it is forbidden to take painkillers on your own, as this can lead to a deterioration in the patient’s condition and interfere with the correct diagnosis.
Treatment in the clinic of Elena Malysheva
In our medical center, gastroenterologists of the highest category with extensive practical experience are receiving appointments. In each case, doctors use an integrated approach to the treatment of pancreatitis:
- develop an individual regimen for taking medications;
- choose a gentle diet;
- adjust the patient’s lifestyle.
Depending on the condition and age of the patients, effective medications are selected – these can be both traditional medicines and innovative means tested in numerous studies and recommended by leading European clinics. With timely treatment, doctors manage to stop the pain syndrome in 90% of cases, improve the patient’s condition and avoid surgical intervention.
If you suffer from recurrent pain in pancreatitis, make an appointment with the experienced gastroenterologists of the clinic of Dr. Elena Malysheva! The administrator will select a convenient time for you to visit the doctor.
Heading health: treatment of pancreatitis – Official website of the Administration of St. Petersburg
The diagnosis of “pancreatitis” is not uncommon today. This disease is an inflammation of the pancreas. Often the existing problems with digestion are perceived by us only as simple errors in food, which by themselves must go away. Unfortunately, in practice, everything happens differently. About pancreatitis and how to prevent it this publication.
Why does inflammation occur in pancreatitis?
The functioning of the pancreas can be disrupted by excessively spicy, fatty and fried foods, overeating, acute or chronic alcohol poisoning, as well as neuropsychic overexcitation, which sharply increases the secretion of pancreatic juice. The attack is caused by the fact that the damaged ducts of the pancreas are not able to drain the juice, and instead of the intestines it enters the tissue of the pancreas, causing its inflammation.Men who are prone to overeating and alcohol abuse, and women during pregnancy and in the early postpartum period are at risk of this disease. In addition, an attack of acute pancreatitis can provoke a peptic ulcer, prolonged use of hormonal drugs. Often acute pancreatitis occurs in diseases of the gallbladder, bile ducts, cholelithiasis, cirrhosis of the liver. Possible causes of an attack of pancreatitis include physical trauma to the abdomen (for example, a shock from a fall).In acute pancreatitis, the patient is hospitalized and stays in the hospital for 3-7 days.
What are the symptoms of pancreatitis?
Symptoms of acute pancreatitis are severe abdominal pain. With this disease, localization of pain is possible in various places of the abdomen: if the head of the pancreas becomes inflamed, then it hurts in the right hypochondrium, if the body of the gland, then in the epigastric region, if the tail, then in the left hypochondrium. But sometimes the pains are of a girdle nature (when the entire pancreas is inflamed).Sometimes the pain radiates to the back and rarely to the sternum and left shoulder blade.
Symptoms of chronic pancreatitis are as follows: poor appetite, vomiting, nausea, bloating, belching, increased salivation, various disorders of the digestive tract, pain in the upper abdomen and back (pain localization is similar to the acute form of the disease). From fatty and spicy food or alcohol in a patient with chronic pancreatitis, exacerbations of the course of the disease are possible in the form of burning, often even boring pain.
How to confirm the diagnosis of pancreatitis?
It can be quite difficult to detect pancreatitis: the pancreas is an organ located very deep in the human body, so its disease is very difficult to diagnose. It is possible to establish the presence of chronic pancreatitis in a patient using modern methods: for example, ultrasound, angiography of the vessels of the gland, study of the activity of blood and urine enzymes. It is important to remember that in addition to pancreatic juice, the pancreas also produces insulin – therefore, chronic pancreatitis can cause diabetes.
How is pancreatitis treated?
Acute pancreatitis is treated only in a surgical hospital: the patient is kept on a strict diet, medications are injected intravenously. The critical period (with severe pain) lasts 2-7 days.
No-shpa can be used to relieve pain in chronic pancreatitis. To suppress increased secretion of the pancreas, phospholugel, almagel are recommended. Sometimes enzyme preparations are prescribed that make up for the lack of pancreatic juice: mezim forte, panzinorm and others.Only an attending physician familiar with the peculiarities of the course of the disease can prescribe a specific treatment for chronic pancreatitis.
Obviously, you need to follow a diet for chronic pancreatitis?
This is especially important in chronic pancreatitis. Increase your protein intake and reduce your intake of fats and carbohydrates, in particular sugar. You should give up coarse fiber, exclude fried foods. You should strive to consume more vitamins.It is advisable to set the diet – 5-6 times a day.
An example menu for the day looks like this:
-First breakfast: for the first you can cook meat, for the second – oatmeal with milk, tea.
-Second breakfast: steamed egg white omelet and rosehip broth.
-Lunch: vegetarian soup from chopped vegetables, any boiled meat dish, boiled potatoes as a side dish, dried fruit compote.
– Afternoon snack: calcined cottage cheese, tea with milk.
-Dinner: prepare fish, carrot puree, milk tea.
-For the night: drink a glass of kefir.
In this case, the diet should contain only low-fat varieties of meat and fish in a boiled, preferably chopped form, no fried foods. Dairy products are allowed, but with a minimum percentage of fat. It is recommended to drink only natural juices that do not contain sugar, as well as tea and decoctions of dry fruits. With pancreatitis, the use of spicy foods, various preserves, smoked and pickled foods, carbonated and alcoholic beverages, sweets is not allowed.In general, the diet of a patient with pancreatitis should be built from rapidly digesting foods. Such a diet, in combination with appropriate treatment, will accelerate the improvement of the patient’s condition.
Can medicinal herbs be used?
To avoid repeated attacks of the disease, the following fees are used. In chronic pancreatitis, herbal medicine is necessary almost constantly, with one-time exacerbations, as a preventive measure, it is necessary to resort to the help of fees twice a year in courses of 1-2 months:
-With aggravated pancreatitis, you can make the following collection: take in equal parts St. John’s wort, motherwort and immortelle flowers.Two tablespoons of the collection pour 0.5 liters of boiling water, leave for an hour, strain and take 50 g before meals.
-This collection is effective: 3 tablespoons of grass of a string, grass elecampane, leaves of coltsfoot in a ratio of 2: 1: 1, pour 0.5 liters of water, boil for 4 minutes, insist in a sealed container for 2 hours. Take in small sips warm 30 minutes before meals for 20 days.
What else can you recommend to patients?
For the prevention of pancreatitis, doctors recommend mastering the techniques of gentle massage of the pancreas with the help of special movements of the abdominal muscles and diaphragm.They will improve blood circulation in this area and the outflow of digestive juices from the pancreas and liver, reduce inflammation, edema and congestion associated with chronic pancreatitis.
Do the exercises several times a day in any position – sitting, lying or standing. Start with 3-4 repetitions, then gradually increase the load up to 9 times. Monitor your well-being: during gymnastics, you should not experience fatigue and pain.
– Inhale, exhale and hold your breath.During a breathing pause, smoothly, but quite strongly, draw in the abdomen, count to 3, and then relax the abdominal muscles.
– Inhale, exhale and hold your breath. During a breathing pause, inflate your abdomen as much as possible, count to 3, and then relax your abdominal muscles.
– Simultaneously with exhalation, draw in the stomach strongly. Holding your breath for a few seconds, relax your abdominal muscles. Actively inflate the belly while inhaling and pull it in again while exhaling.
How to eat properly with pancreatitis
If you still can’t lose weight after the May holidays, it’s time to take on yourself.The main thing is that your diet is not like these.
1. Purification with juice
Rules: Eating without solid food. Instagram often offers detox programs that include six or so ready-to-drink fruit and vegetable juices throughout the day. There are many iterations of this diet, for example, Victoria’s Secret angel Adriana Lima says she follows an all-liquid diet before fashion shows. Nine days before the big event, she drinks protein shakes made from egg powder and water.
Promise: Because this ultra-low-calorie diet prohibits the solid foods you are accustomed to eating, you will eat fewer calories without having to follow many complicated rules. This creates a calorie deficit that promotes weight loss.
Reality: “The five kilograms in three days that you will lose after a juice cleanse is usually the weight of water from your muscles, not fat,” explains Charlie Seltzer, MD, weight loss specialist in Philadelphia. , Pennsylvania.“After completing the program, your body will not be much different from what you saw before, and you will gain the same amount just by looking at the croissant,” he adds.
2. Purification with activated carbon
Rules: you are drinking juice containing activated charcoal.
Promise : Your body cannot absorb activated charcoal, so it passes through your digestive system intact. Because it clings to toxins in the body, it removes impurities such as pesticides and any harmful substances found in inorganic or processed foods.Diet aficionados say it improves skin health, digestion and organ function.
Reality: “You think you are flushing out toxins from your body, but charcoal does not travel through your entire body – only through your intestines, where it can bind to nutrients and suck them out,” Zeltser explains. “Our body processes toxins quite well, and your chances of dying from toxins in food are lower than your risk of dying from obesity. If you want to reduce the amount of toxins in your body, avoid unhealthy foods, ”he adds.
3. Diet Shangri-La
Source here and below: Pexels
Rules: You drink very light olive oil or unscented sugar water between meals.
Promise: Eating a variety of flavorful foods stimulates hunger and makes you gain weight. By consuming soft foods, you fight hunger, while you do not have cravings for food, so you end up eating less and losing weight.
Reality: “Not a bad idea,” says Dr. Seltzer. “For some people, a wide variety of foods stimulates their appetite. But if you eat the same food every day, you get bored and crave more varied foods. Success is likely to depend on the individual. But I would use whey protein instead of olive oil between meals because it will satisfy your appetite with fewer calories. ”
4. Diet based on baby food
Rules: This weight loss diet involves eating up to 16 cans of baby food a day in place of regular meals and snacks.
Promise: According to Tracey Anderson, personal trainer Gwyneth Paltrow, who is credited with creating the program, it creates a calorie deficit that promotes weight loss, detoxifies the body and helps break bad habits.
Reality: Although baby food is cooked to a minimum, Dr. Seltzer disapproves of it: “This is a gimmick. If you look at people with healthy bodies, no one will tell you that they adhere to the children’s menu.This is ridiculous”.
5. Diet Vision
Rules: you eat everything with glasses with blue tones.
Promise: This diet, based on the idea that red and yellow foods are tastier (eg, meat, fries, ripe fruits), is designed to make your food less appetizing. In theory, this makes you eat less.
Reality: “It doesn’t seem right to me,” says Dr. Seltzer.”But if it makes people slimmer, there is no downside.” Except for the fact that in a restaurant, you will look a little strange.
6. Diet with a pinch of the nose while eating
Rules: Cover your nose so you don’t smell while eating.
Promise: This will dull your sense of taste and help you focus on your real appetite. That is, you will stop eating when you are full.
Reality: “The smell really stimulates the appetite, but how are you going to eat lunch every time you close your nose? No normal person will do this in the long term, ”says Dr. Seltser.
7. Diet based on ice cream
Rules: You eat two and a half special ice cream a day (diet ice cream is made with coconut cream and honey).
Promise: Ice cream creates a calorie deficit that leads to weight loss. And you can eat ice cream all day.
Reality: “Any calorie deficit will lead to weight loss, but it can also cause nutritional deficiencies.However, you cannot eat ice cream for the rest of your life.
8. Diet based on maple syrup and cayenne pepper
Rules: you should drink lemon, maple syrup and cayenne pepper water throughout the day; laxative tea at night.
Promise: is an extremely low calorie diet with ingredients (such as cayenne pepper) known to boost metabolism.
Reality: “I’d rather you eat every day at McDonald’s than do it,” says Dr. Seltzer.”Forcing you to drink an ugly-tasting drink will not work in the long run as it will scare you away and detach you from reality.”
9. Diet on Coca-Cola
Rules: you drink six to nine cans of sugar-free cola a day.
Promise : sparkling water will give you a feeling of fullness, you will not be hungry.
Reality: “Anything that restricts calorie intake will lead to weight loss in the short term,” says Dr. Seltzer, “but anyone looking to lose weight by drinking a few cans of cola a day is in trouble.”This is because when you drastically cut your calorie intake, your metabolism slows down. When you return to the normal menu, you will gain weight again.
10. Diet with cotton balls
Rules: You eat up to five cotton balls (or the equivalent amount of tissue paper) dipped in orange juice, lemonade, or smoothies in one sitting.
Promise: you fill your stomach without consuming enough calories to gain weight.
Reality: “This sounds crazy to me,” says Dr. Seltzer. “I’m not a gastroenterologist, but I can’t imagine what will happen to your stomach or intestines after such a diet.”
90,000 🧬 Pancreatitis: causes, symptoms and treatment
In Russia, pancreatitis is one of the most popular diagnoses. It is customary to explain to them almost any pain in the abdomen, and often it is “diagnosed” by ultrasound of the pancreas in a person without any symptoms.We understand the intricacies of the disease together with Ph.D., GMS Clinic gastroenterologist Alexei Golovenko.
What is pancreatitis
Pancreatitis is inflammation of the pancreas. This organ secretes enzymes into the duodenum (just behind the stomach) that help digest food: for example, amylase (to break down carbohydrates) and lipase (to break down fats). With severe inflammation of the pancreas – acute pancreatitis – its cells are destroyed and enzymes enter the blood.Therefore, for any severe abdominal pain, doctors determine the level of amylase in the blood.
Acute pancreatitis is a painful and very dangerous disease. Its symptoms are almost impossible to endure “on the legs”: it is the strongest persistent pain under the spoon and under the left rib, which often radiates to the back (the so-called girdle pain occurs). A person with acute pancreatitis often even takes a special position on the bed – lying on his left side, so as not to increase the pain by movements of the ribs when breathing.Most people with acute pancreatitis experience severe nausea and vomiting, any meal increases pain: after all, the pancreas begins to secrete enzymes when eating, and this increases blood flow, and therefore pain. Many people have a rise in body temperature.
Diagnosis of acute pancreatitis is not so much for gastroenterologists as for surgeons, since the intensity of pain can be the same as in appendicitis and other “surgical” pathology.
How acute pancreatitis occurs
About 70% of all cases of acute pancreatitis are due to either alcohol poisoning or gallstone disease.Excessive alcohol consumption (even without a history of alcoholism) causes inflammation of the pancreas. For the same reason, people who systematically abuse alcohol have every chance not only to end up in the hospital with severe acute pancreatitis, but also to experience pain attacks for many years. A gallbladder stone can also cause pancreatitis: the duct that carries bile from the bladder into the duodenum merges with the pancreatic duct. This situation – biliary pancreatitis – requires emergency intervention, for example, to dissect the large duodenal papilla: this is the place where the ducts enter the intestine.
Acute pancreatitis can also cause toxic effects of certain medications, trauma to the gland during surgery, or high blood fat levels. It is extremely rare and, as a rule, in the presence of other similar diseases, the pancreas becomes inflamed due to the excessive action of the immune system on it.
Whatever the cause of the onset of the disease, acute pancreatitis is always accompanied by abdominal pain. It is not worth assuming this diagnosis if you feel unwell from a medicine or some product.
Sorted out with acute pancreatitis. What about chronic?
If the toxic effect on the pancreas does not stop (for example, the person continues to abuse alcohol) or the organ was very badly damaged during the first (acute) episode of pancreatitis, the pain recurs again and again.
With exacerbations of chronic pancreatitis, blood tests may remain normal. But over time, external signs may appear, which doctors find by examining the pancreas using ultrasound (ultrasound), X-ray (CT, or computed tomography) or magnetic resonance imaging (MRI).These are narrowing of the pancreatic ducts, the appearance of seals in it – calcifications, as well as the appearance of cysts – bubbles with fluid in place of the dead tissue. Examination for suspected chronic pancreatitis is carried out with another important goal – not to miss pancreatic cancer, which may initially be accompanied by the same symptoms.
With a constantly renewed inflammation of the pancreas, over time, its function is disrupted – the secretion of enzymes that digest food.As a result, a person is worried about constant bloating, diarrhea, and the stool becomes greasy (for example, it is poorly flushed off the toilet). This condition – exocrine insufficiency – is most conveniently detected by determining the content of pancreatic elastase (pancreatic enzyme) in the stool.
How to treat chronic pancreatitis
In general, the point of treatment for chronic pancreatitis is to eliminate pain. To do this, use anti-inflammatory drugs, such as paracetamol.Enzymes are often prescribed for people with chronic pancreatitis. Alas, this does not always relieve pain. Previously, it was assumed that adding enzymes to food would reduce the load on the pancreas – it would not have to secrete its own enzymes. In fact, everything is not so simple: the secretory (excretory) activity of the gland depends entirely on other substances – hormones, for example, secretin. Their products are more influenced by the fat content of food and the regularity of its intake than the content of enzymes-drugs in the intestine.Nevertheless, enzymes in chronic pancreatitis must be prescribed (often for life) if there are signs of poor secretion of their own enzymes (bloating, loose stools). Enzymes are always drunk directly with food: “between the spoons.” For the same reason, it is illiterate to prescribe the intake of enzymes “so many times a day.” It is more correct to warn a person with a disease that the drug should be carried with you and taken with any food intake.
Diet for chronic pancreatitis facilitates the course of the disease, although it is difficult to accurately determine the list of possible foods the first time.It is definitely impossible to consume except alcohol, but traditionally it is recommended to eat less fatty foods and snack more often, giving preference to slow carbohydrates – fruits and vegetables. Cooking exclusively with steam is not the most proven way to alleviate the course of pancreatitis, it is much more important not to overuse very spicy foods. Roughly speaking, chicken cutlet, even if fried without abundant addition of seasonings, most likely will not harm.
The main thing in the treatment of chronic pancreatitis is to remove the cause of the disease.
If a person suffers from alcoholism or smokes, refer him to a narcologist (smoking in itself does not cause pancreatitis, but increases the frequency of exacerbations). If pancreatitis is due to gallstones, remove the bladder. If the metabolism of fats is disturbed in the body, consult a cardiologist and choose a treatment with drugs that reduce the level of lipoproteins and triglycerides, choose a diet.
Most of my acquaintances have been diagnosed with pancreatitis, but they do not drink alcohol and have never been admitted to the hospital with severe pain.What’s wrong?
Most likely, like many other Russians, the diagnosis of pancreatitis in such a situation was made solely based on the results of an ultrasound scan. A competent specialist in ultrasound diagnostics will not diagnose a therapist, gastroenterologist or surgeon. He will only describe the changes and invite a colleague to interpret the changes in the pancreas himself. Often, the so-called diffuse changes in the pancreas become a reason to diagnose pancreatitis in a person without any symptoms at all.It is not right.
It is possible to reliably judge pancreatitis with ultrasound, strictly speaking, only by detecting obvious complications of the disease – narrowing and widening of the duct, calcifications, cysts.
Yes, and the ultrasound method, like any diagnostic method, the possibilities are not limitless. In true pancreatitis, magnetic resonance imaging or endoscopic cholangiopancreatography is preferred. With these methods, a very accurate image of the pancreatic ducts is obtained.
Diffuse changes in the pancreas most often turn out to be a rather harmless accumulation of adipose tissue in the gland. In the absence of the typical symptoms of chronic pancreatitis – exhausting pain after eating in a person who has already had acute pancreatitis, such an ultrasound picture should only become a reason to check cholesterol and, perhaps, more actively fight overweight. In addition, very often the most common diseases in gastroenterology – functional disorders, such as irritable bowel syndrome – are mistaken for chronic pancreatitis.This is a harmless, but very unpleasant disease in which the intestine becomes too sensitive to gas and food stretching, reacting with spasm (colic). Very often, this functional pain (that is, pain not associated with inflammation or swelling) occurs in people under constant stress. Therefore, the treatment of functional pain is not only taking antispasmodic drugs and other gastroenterological drugs, but also working with a psychoemotional state: cognitive-behavioral psychotherapy, increasing physical activity and even yoga.
Not every abdominal pain is pancreatitis. And it pleases.
Why can’t abdominal pain be tolerated and what is the danger of acute pancreatitis?
Diseases of the gastrointestinal tract are not so terrible compared to those that the whole world fears (such as cancer and AIDS), and nevertheless.
What is pancreatitis?
Gennady Kondratenko, Head of the 1st Department of Surgical Diseases of the Belarusian State Medical University, Doctor of Medical Sciences, Professor:
The pancreas, in general, meets two tasks in the body, the most important, fundamentally very important tasks.This is the first – it participates in the digestive conveyor, and second – it regulates blood sugar.
Inflammation of the pancreas in acute or chronic form – this is called pancreatitis. It should be noted right away that the incidence of acute pancreatitis has a worldwide upward trend. The attention of the surgical community around the world, including our Belarusian surgical community, is riveted to this disease. We see growth in Belarus, including severe forms of pancreatitis, and we are concerned about this.
Gennady Kondratenko: “The incidence of acute pancreatitis has a worldwide tendency to increase. We see growth in Belarus, including severe forms of pancreatitis, we are concerned about this. ”
Interesting fact. We are afraid of heart attack, stroke, cancer – the main leaders in mortality in the world. And we completely forget, or rather, know little about such an insidious disease as pancreatitis.
Aleksey Protasevich, Associate Professor of the 1st Department of Surgical Diseases of the Belarusian State Medical University, Candidate of Medical Sciences:
We can say that this is even a fatal disease.Particularly acute pancreatitis is a potentially fatal illness.
Alexey Protasevich: “We can say that this is even a fatal disease. Particularly acute pancreatitis is a potentially fatal disease. ”
Due to its unpredictability and transience.
Dies somewhere in the range of 20-30% of cases.
So what is this monster that can take a person’s life in the blink of an eye?
This is the death of pancreatic tissue.
It would seem that a very small organ is no more than 50 g of weight, and its disease can lead to malfunctioning of other vital organs.
In the beginning, to malfunction of the heart, lungs, liver, kidneys, and sometimes the brain. If you do not detoxify, your patient could die of heart failure.
Fortunately, this organ has one plus. Let’s face it: somewhat encouraging.
The pancreas is created with a large margin of safety.You may not have 90% of your pancreas, and you will not have diabetes or enzyme deficiency. Therefore, in principle, the Lord God created the pancreas in earnest.
And to damage it, you really have to try.
Causes of the development of the disease
For men, in the overwhelming majority of cases, the reason is alcohol intake.
And in any form and in any quantity.
If a person regularly and drinks a lot of alcohol, he develops 100% cirrhosis of the liver.
And a single dose is enough for the development of pancreatitis.
The so-called alcohol excess can lead to the development of severe acute pancreatitis.
Alexey Protasevich: “The so-called alcohol excess can lead to the development of severe acute pancreatitis.”
For women, the main cause of pancreatitis can be a disease of the gallbladder and bile ducts.What is the connection, you ask? Yes, the most direct one.
Bile enters the duodenum through a duct that passes through the head of the pancreas. Immediately before entering the duodenum, the pancreatic duct merges with the bile duct.
Such anatomical proximity leads to the fact that the ill-fated stones injure the pancreas, thereby causing pancreatitis in women. The insidiousness of the disease also lies in the fact that in some cases the cause of its occurrence cannot be established.
This is the so-called idiopathic pancreatitis. A number of reasons remain closed, since there is a connection with genes, with the patient’s innate predisposition to the development of this particular disease.
Alexey Protasevich : “A number of reasons remain closed, since there is a connection with genes, with the patient’s innate predisposition to the development of this particular disease.”
Fortunately, such cases are few – about 10% of the total number of cases.So judge for yourself that in the overwhelming majority it becomes the reason for the development of such an unpredictable disease – our very predictable actions. And this is a fact.
This occurs when small, long-term recurrent inflammation of the pancreatic tissue leads to degeneration of this tissue and the replacement of this functional tissue by connective scar tissue. Thus, the digestive function of the pancreas becomes weaker, there are problems with digestion in these patients, there are moderate persistent or recurrent pain in the upper abdomen, upset stools, and diarrhea.Such patients also need to be treated with substitution therapy, a diet must be constantly followed.
The reason for its development is the same: excessive consumption of alcohol, let’s say, and food, especially fatty and spicy foods, well, and also long-term wearing of stones, gallstone disease, which is not operated on in a timely manner. Then, when a person already has a chronic form of pancreatitis, does not pay attention to it, leads an unhealthy lifestyle, a picture develops that is almost completely identical to acute pancreatitis.
Gennady Kondratenko: “When a person already has a chronic form of pancreatitis, does not pay attention to it, leads an unhealthy lifestyle, a picture develops that is almost completely identical to acute pancreatitis”.
I would like to note that this acute onset requires immediate delivery to the emergency rooms of those hospitals where there are surgical departments.Why a surgical hospital? Because it is still a surgical disease. In some cases, surgery will be indicated for this disease.
There are very severe forms of pancreatitis, which can be treated in intensive care. The only wish, of course, is not to go too much, perhaps, to the polyclinic, because slowing down with the provision of assistance plays an essential role in the further course of pancreatitis.
Patients with acute pancreatitis are most often admitted to the hospital in a severe form for one simple reason – late treatment.
Anastasia Khatkovskaya, anesthesiologist-resuscitator:
For a day, two, some stay at home for a week, at best, self-medicate, at worst – do nothing. Many people abuse alcohol the day before and often do not even remember the onset of the symptoms.
Anastasia Khatkovskaya : “For a day, two, some stay at home for a week, at best, self-medicate, at worst – do nothing. Many people abuse alcohol the day before and often do not even remember the onset of symptoms. “
These are perhaps the most common mistakes made by patients.
Yan Kernozhitskiy, surgeon of the 1st emergency surgical department of the Healthcare Institution “10th City Clinical Hospital of Minka”:
We are used to doing everything “at random”. And suddenly it will pass. You hear all this in 100% of those who arrived on the second or third day.
For many, this “maybe” costs their lives.
We are wasting time to start massive infusion therapy.
Therefore, once again about the symptoms.
The main clinical manifestation of acute pancreatitis is epigastric pain.
Or, as the townsfolk say, “under the spoon”. Pain can radiate to the right or left hypochondrium. And is, as a rule, shingles.
Alexey Protasevich : “The main clinical manifestation of acute pancreatitis is epigastric pain.”
Further downward – this is nausea, vomiting, as a rule, indomitable, then bloating, then general symptoms of intoxication in the form of tachycardia, shortness of breath, general weakness.
Unfortunately, acute pancreatitis can be disguised as other diseases.
Most often confused with gastritis and peptic ulcer disease.
Hence the late appeal for medical help and, as a consequence.decrease in the effectiveness of the therapy.
Alexey Protasevich: “Most often confused with gastritis and peptic ulcer disease.”
A person turns into a dehydrated state, because a very large loss of fluid goes to the inflammatory process that occurs in the abdomen, blood thickens. Therefore, the first aid that we provide, as anesthesiologists and resuscitators, is massive infusion therapy.
Often infusion reaches 6-8 liters of fluid per day.
Without this, a person, in principle, within a day or two can go into intoxication shock and die.
Here, in the intensive care unit, the simplest but proven method of diagnostics is carried out – ultrasound examination.
If we are talking about a serious one, if we need to know all the information about the state of the pancreas, this is, of course, computed tomography.Now there is work on magnetic resonance imaging. It seems to provide almost the same amount of information as CT.
If the patient’s body does not adequately respond to therapy from the first days of treatment or surgery is planned, doctors use another diagnostic method.
The so-called endosonoscopy. This is an endoscopy, but when a small ultrasound probe is attached to the endoscope probe. And we actually put the sensor through the duodenum on the pancreas, and therefore we get a very detailed one.a very reliable picture of the state of the pancreas.
Finally, a classic blood test.
To increase the enzymes in it of the pancreas. That is, these are three signs of acute pancreatitis – the presence of pain, increased enzymes and ultrasound signs of inflammation of the pancreas.
Alexey Protasevich : “Three signs of acute pancreatitis are the presence of pain, increased enzymes and ultrasound signs of inflammation of the pancreas.”
If the patient was admitted two days later, three days after the onset of the disease, of course, it is no longer possible to interrupt the process. The process has been launched, a cascade of pathological mechanisms has been launched.