Pancreatitis Symptoms

Acute Pancreatitis Symptoms
The most common symptom of acute pancreatitis is pain. Almost everybody with acute pancreatitis experiences pain.

• The pain may come on suddenly or build up gradually. If the pain begins suddenly, it is typically very severe. If the pain builds up gradually, it starts out mild but may become severe.
• The pain is usually centered in the upper middle or upper left part of the belly (abdomen). The pain may feel as if it radiates through to the back.
• The pain often begins or worsens after eating.
• The pain typically lasts a few days.
• The pain may feel worse when a person lies flat on his or her back.

People with acute pancreatitis usually feel very sick. Besides pain, people may have other symptoms.

• Nausea (Some people do vomit, but vomiting does not relieve the symptoms.)
• Fever, chills, or both
• Swollen abdomen which is tender to the touch
• Rapid heartbeat (A rapid heartbeat may be due to the pain and fever, or it may be a compensation if a person is bleeding internally.)

In very severe cases with infection or bleeding, a person may become dehydrated and have low blood pressure, in addition to the following symptoms:

• Weakness or feeling tired (fatigue)
• Feeling lightheaded or faint
• Lethargy
• Irritability
• Confusion or difficulty concentrating
• Headache

If the blood pressure becomes extremely low, the organs of the body do not get enough blood to carry out their normal functions. This very dangerous condition is called circulatory shock or is referred to simply as shock.

Chronic Pancreatitis Symptoms

Pain is less common in chronic pancreatitis.
Some people have pain, but most people do not experience pain. For those people who do have pain, the pain is usually constant and may be disabling; however, the pain often goes away as the condition worsens. This lack of pain is a bad sign because it probably means that the pancreas has stopped working.
Other symptoms of chronic pancreatitis are related to long-term complications, such as the following:

• Inability to produce insulin (diabetes)
• Inability to digest food (weight loss and nutritional deficiencies)
• Bleeding (low blood count, or anemia)
• Liver problems (jaundice)

When to Seek Medical Care
In most cases, the pain and nausea associated with pancreatitis are severe enough that a person seeks medical attention from a healthcare provider. Any of the following symptoms definitely warrant medical attention:

• Inability to take medication or to drink and eat because of nausea or vomiting
• Severe pain not relieved by nonprescription medications
• Difficulty breathing
• Pain accompanied by fever or chills, persistent vomiting, feeling faint, weakness, or fatigue
• Pain accompanied by presence of other medical conditions, including pregnancy

The healthcare provider may tell the person to go to a hospital emergency department. If a person is unable to reach a healthcare provider, or if a person's symptoms worsen after having visited a healthcare provider, an immediate visit to an emergency department is necessary.

Exams and Tests
When a healthcare provider identifies symptoms suggestive of pancreatitis, specific questions are asked about the person's symptoms, lifestyle and habits, and medical and surgical history. The answers to these questions and the results of the physical examination allow the healthcare provider to rule out some conditions and to zero-in on the correct diagnosis.

In most cases, laboratory tests are needed. The tests check for several possibilities, including the following:

• Pancreas, liver, and kidney functions (including levels of pancreatic enzymes amylase and lipase)
• Signs of infections
• Blood cell counts indicating signs of anemia
• Pregnancy test
• Blood sugar, electrolyte levels (an imbalance suggests dehydration) and calcium level

Results of the blood tests may be inconclusive if the pancreas is still making digestive enzymes and insulin.
Diagnostic imaging tests are usually needed to look for complications of pancreatitis, including gallstones.
Diagnostic imaging tests may include the following:

• X-ray films may be ordered to look for complications of pancreatitis as well as for other causes of discomfort.
• A CT scan is like an x-ray film, only much more detailed. A CT scan shows the pancreas and possible complications of pancreatitis in better detail than an x-ray film. A CT scan highlights inflammation or destruction of the pancreas.
• Ultrasound is a very good imaging test to examine the gallbladder and the ducts connecting the gallbladder, liver, and pancreas with the small intestine.

1. Ultrasound is very good at depicting abnormalities in the biliary system, including gallstones and signs of inflammation or infection.
2. Ultrasound uses painless sound waves to create images of organs. Ultrasound is performed by gliding a small handheld device over the abdomen. The ultrasound emits sound waves that "bounce" off the organs and are processed by a computer to create an image. This technique is the same one that is used to look at a fetus in a pregnant woman.

• Endoscopic retrograde cholangiopancreatography (ERCP) is an imaging test that uses an endoscope (a thin, flexible tube with a tiny camera on the end) to view the pancreas and surrounding structures.

1. ERCP is usually used only in cases of chronic pancreatitis or in the presence of gallstones.
2. To perform an ERCP, a person is first sedated. After sedation, an endoscope is passed through the mouth, to the stomach, and into the small intestine. The device then injects a temporary dye into the ducts connecting the liver, gallbladder, and pancreas with the small intestine (biliary ducts). The dye makes is easier for the healthcare provider to see any stones or signs of organ damage. In some cases, a stone can be removed during this test.

Pancreatitis Treatment

Self-Care at Home
For most people, self-care alone is not enough to treat pancreatitis. People may be able to make themselves more comfortable during an attack, but they will most likely continue to have attacks until treatment is received for the underlying cause of the symptoms. If symptoms are mild, people might try the following preventive measures:

• Stop all alcohol consumption.
• Adopt a liquid diet consisting of foods such as broth, gelatin, and soups. These simple foods may allow the inflammation process to get better.
• Over-the-counter pain medications may also help.

Medical Treatment
Medical treatment is usually focused on relieving symptoms and preventing further aggravation to the pancreas. Certain complications of either acute pancreatitis or chronic pancreatitis may require surgery or a blood transfusion.
Acute Pancreatitis Treatment
In acute pancreatitis, the choice of treatment is based on the severity of the attack. If no complications are present, care usually focuses on relieving symptoms and supporting body functions so that the pancreas can recover.

• Most people who are having an attack of acute pancreatitis are admitted to the hospital.
• Those people who are having trouble breathing are given oxygen.
• An IV line is started, usually in the arm. The IV line is used to give medications and fluids. The fluids replace water lost from vomiting or from inability to take in fluids, helping the person to feel better.
• If needed, medications for pain and nausea are prescribed.
• Antibiotics are given if the health care provider suspects an infection may be present.
  No food or liquid should be taken by mouth for a few days. This is called bowel rest. By refraining from food or liquid intake, the intestinal tract and pancreas are given a chance to start healing.
• Some people may need a nasogastric (NG) tube. The thin, flexible plastic tube is inserted through the nose and down into the stomach to suck out the stomach juices. This suction of the stomach juices rests the intestine further, helping the pancreas to recover.
• If the attack lasts longer than a few days, nutritional supplements are administered through an IV line.

Chronic Pancreatitis Treatment
In chronic pancreatitis, treatment focuses on relieving pain and avoiding further aggravation to the pancreas. Another focus is to maximize a person's a

ility to eat and digest food.

• Unless people have severe complications or a very severe episode, they probably do not have to stay in the hospital.
• Medication is prescribed for severe pain.
• A high carbohydrate low fat diet; and eating smaller more frequent meals help prevent aggravating the pancreas. If a person has trouble with this diet, pancreatic enzymes in pill form may be given to help digest the food.
• People diagnosed with chronic pancreatitis are strongly advised to stop drinking alcohol.
  If the pancreas does not produce sufficient insulin, the body needs to regulate its blood sugar, and insulin shots may be necessary.

Surgery
If the pancreatitis is caused by gallstones, an operation to have the gallbladder and gallstones removed (cholecystectomy) is likely.
If certain complications (for example, enlargement or severe injury of the pancreas, bleeding, pseudocysts, or abscess) develop, surgery may be needed to drain, repair, or remove the affected tissues.