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Symptoms and Signs of Acute and Chronic Pancreatitis

Doctor's Notes on Pancreatitis Symptoms, Causes, Diet, and Treatment

Pancreatitis refers to inflammation of the pancreas, an organ in the upper abdomen. The main function of the pancreas is to secrete hormones and enzymes to aid digestion and regulate blood glucose. Pancreatitis may be an acute (coming on suddenly) illness or may progress over time (chronic pancreatitis). Although there are a number of possible causes, gallstones and alcohol consumption are the most common causes of pancreatitis.

Pancreatitis leads to characteristic symptoms, which include pain in the abdomen that may radiate to the back, nausea, vomiting, and pain that worsens after eating. Associated symptoms can include fever, chills, lethargy, weakness, weight loss, and tenderness of the abdomen. If pancreatitis progresses, it can lead to complications such as diabetes, cancer of the pancreas, malnutrition, infection, or development of pseudocysts, a form of scarring in the pancreas.

Medical Author:
Medically Reviewed on 3/11/2019

Pancreatitis Symptoms, Causes, Diet, and Treatment Symptoms

Pain is less common in chronic pancreatitis than in acute pancreatitis. Some people have pain, but many people do not experience abdominal 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)

What are the risk factors for pancreatitis?

The major risk factors for pancreatitis are excessive alcohol intake and gallstones. Although the definition for excessive alcohol intake can vary from person-to-person, most health-care professionals suggest that moderate consumption is no more than two alcoholic beverages a day for men and one a day for women and the elderly. However, people with pancreatitis secondary to alcohol intake are usually advised to avoid all alcohol intake.

Other risk factors include

  • a family history of pancreatitis,
  • high levels of fat (triglycerides) in the blood,
  • cigarette smoking,
  • certain inherited disorders such as cystic fibrosis, and
  • taking certain medicines (for example estrogen therapy, diuretics, and tetracycline).

The most common symptom of acute pancreatitis or pancreas pain is abdominal pain. Almost everybody with acute pancreatitis experiences abdominal 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 is often described as if it radiates from the front of the abdomen 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 and signs.

  • 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, dehydration from vomiting and not eating, or it may be a compensation mechanism 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
  • Cullen's sign (bluish skin around the belly button)
  • Grey-Turner sign (reddish-brown skin discoloration along the flanks)
  • Erythematous skin nodules

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 and is referred to simply as shock.

Severe acute pancreatitis is a medical emergency.

Pancreatitis Symptoms, Causes, Diet, and Treatment Causes

Alcohol abuse and gallstones are the two main causes of pancreatitis, accounting for 80% to 90% of all individuals diagnosed with pancreatitis.

Pancreatitis from alcohol use usually occurs in individuals who have been long-term alcohol drinkers for at least five to seven years. Most cases of chronic pancreatitis are due to alcohol abuse. Pancreatitis is often already chronic by the first time the person seeks medical attention (usually for severe pain).

Gallstones form from a buildup of material within the gallbladder, another organ in the abdomen (please see previous illustration). A gallstone can block the pancreatic duct, trapping digestive juices inside the pancreas. Pancreatitis due to gallstones tends to occur most often in women older than 50 years of age.

The remaining 10% to 20% of cases of pancreatitis have various causes, including the following:

  • medications,
  • exposure to certain chemicals,
  • injury (trauma), as might happen in a car accident or bad fall leading to abdominal trauma,
  • hereditary disease,
  • surgery and certain medical procedures,
  • infections such as mumps (not common),
  • abnormalities of the pancreas or intestine, or
  • high fat levels in the blood.

In about 15% of cases of acute pancreatitis and 40% of cases of chronic pancreatitis, the cause is never known.

What's Causing Your Abdominal Pain? Slideshow

What's Causing Your Abdominal Pain? Slideshow

The abdomen is an anatomical area that is bounded by the lower margin of the ribs and diaphragm above, the pelvic bone (pubic ramus) below, and the flanks on each side. Although abdominal pain can arise from the tissues of the abdominal wall that surround the abdominal cavity (such as the skin and abdominal wall muscles), the term abdominal pain generally is used to describe pain originating from organs within the abdominal cavity. Organs of the abdomen include the stomach, small intestine, colon, liver, gallbladder, spleen, and pancreas. Abdominal pain can range in intensity from a mild stomach ache to severe acute pain. The pain is often nonspecific and can be caused by a variety of conditions.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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