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Pancreatitis (cont.)

Treatment Overview

Treatment of pancreatitis depends on whether you have a sudden (acute) attack of pancreatitis or you have had the condition for a long time (chronic).

Initial treatment

For acute pancreatitis. You will receive treatment in the hospital to allow the pancreas to heal. You will receive intravenous (IV) fluids to replace lost fluids and maintain your blood pressure. And you will get medicines to control pain until the inflammation goes away.

To help rest your pancreas, you likely will not be given anything to eat for 3 to 7 days.

If gallstones are causing pancreatitis, you may have a procedure called endoscopic retrograde cholangiopancreatogram (ERCP) to remove the stones from the common bile duct. After recovering from pancreatitis, you may have surgery to remove the gallbladderClick here to see an illustration.. This surgery often prevents future attacks of pancreatitis. For more information, see the Surgery section of this topic.

For chronic pancreatitis. People who have chronic pancreatitis also may have episodes of acute pancreatitis, which are treated the same as an initial episode of acute pancreatitis.

Ongoing treatment

Excessive use of alcohol causes most cases of chronic pancreatitis. It is extremely important that you not drink any alcohol. Drinking even small amounts can cause severe pain and complications. Drinking large amounts of alcohol when you have chronic pancreatitis can shorten your life. For more information on quitting alcohol, see the topic Alcohol Abuse and Dependence.

If you have chronic pancreatitis, you may struggle with ongoing pain. Treatment for pain includes avoiding alcohol, eating a low-fat diet, using pain medicine, and in some cases taking enzyme pills to help rest your pancreas.

You may need surgery or another procedure to widen a narrow pancreatic duct or to remove tissue or stones that are blocking the pancreatic duct. Surgery can also drain a pseudocyst or an obstructed duct.

Your doctor will want to see you every 3 to 6 months to make sure that your pain medicine is helping you and that you do not have complications of chronic pancreatitis. Complications of chronic pancreatitis may include recurring flare-ups of symptoms, fluid buildup, and blockage of a blood vessel, the bile duct, or the small intestine. Chronic pancreatitis also increases your risk of pancreatic cancer.

Treatment if the condition gets worse

In advanced chronic pancreatitis, your body may not absorb fat. This causes loose, oily, especially foul-smelling stools (called steatorrhea). You may lose weight as a result, because your pancreas no longer produces the enzymes you need to digest fat and protein. Pancreatic enzyme pills can replace lost enzymes.

You may need insulin if your pancreas has stopped producing enough of it.

If infection develops, you may need antibiotics and you might have surgery to remove the infected and dead tissue. But surgery is avoided when possible, because the pancreas is damaged easily.

You may need surgery if you develop complications from acute or chronic pancreatitis. Surgery also may be done if there is no infection and your condition has not improved.

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