What Are the Signs & Symptoms of Pancreatitis?

Reviewed on 8/12/2021

Warning signs of pancreatitis include symptoms such as sudden, severe, constant pain in the upper part of the abdomen; pain that wraps around the upper body or radiates to the back; and pain that usually lasts for days and is frequently relieved by leaning forward. People with gallstone pancreatitis or alcoholic pancreatitis may experience different symptoms.
Warning signs of pancreatitis include symptoms such as sudden, severe, constant pain in the upper part of the abdomen; pain that wraps around the upper body or radiates to the back; and pain that usually lasts for days and is frequently relieved by leaning forward. People with gallstone pancreatitis or alcoholic pancreatitis may experience different symptoms.

Pancreatitis is inflammation of the pancreas, an organ that makes hormones and digestive juices that help break down food, that can cause sudden and severe abdominal pain.

Warning signs of pancreatitis include:

  • Sudden, severe, constant pain in the upper part of the abdomen
  • Pain may wrap around the upper body and involve the back in a band-like pattern or radiate directly to the back
  • Pain usually lasts for days and is frequently relieved by leaning forward

People who have gallstone pancreatitis may experience gallbladder pain before pancreatic pain. Gallbladder pain (also called biliary colic):

  • Often follows a meal 
  • Occurs in the right upper abdomen, extending to the back and right shoulder
  • Gradually increases in intensity and is constant
  • May be accompanied by nausea and vomiting 

People who have alcoholic pancreatitis, may also experience acute pancreatitis

  • Symptoms usually occur one to three days after an alcohol binge or after stopping drinking
  • Pain is accompanied by nausea and vomiting 
  • Shock or coma (in severe cases)

What Causes Pancreatitis?

Causes of pancreatitis include: 

  • Gallstones (gallstone pancreatitis)
  • Alcohol abuse (alcoholic pancreatitis)
  • Drug-induced pancreatitis
  • Post-endoscopic retrograde cholangiopancreatography (ERCP) 
    • A procedure performed to evaluate the gallbladder or pancreas
    • About 3 to 5 percent of people who undergo ERCP experience ERCP-induced pancreatitis, which is usually mild
  • Hereditary conditions 

In about 20% of people, there is no underlying identifiable cause (called idiopathic pancreatitis). 

How Is Pancreatitis Diagnosed?

Pancreatitis is diagnosed with a medical history and physical examination. Tests used to help confirm pancreatitis or to rule out other conditions include: 

  • Blood tests for pancreatic enzymes
  • Imaging tests
  • Endoscopic retrograde cholangiopancreatography (ERCP)
    • Used to remove stones from the bile duct if pancreatitis is due to gallstones or other problems with the bile or pancreatic ducts
    • Can also be used to treat some causes of pancreatitis

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What Is the Treatment for Pancreatitis?

Pancreatitis usually requires hospitalization. 

Treatment for mild pancreatitis includes simple supportive care, such as: 

  • Monitoring of vital signs
  • Pain medications 
  • Intravenous (IV) fluids
  • Patients may not be allowed to eat anything during the first few days if significant nausea with vomiting is present

Treatment for moderately severe and severe acute pancreatitis requires more extensive monitoring and supportive care, such as:

  • Intravenous fluids to prevent dehydration
  • Feeding tube or nutrition through an intravenous line placed in the upper chest
  • Antibiotics to prevent infections and control existing infections 
  • In severe cases, damaged and/or infected pancreatic tissue may be drained into the stomach or duodenum or removed (necrosectomy)

Treatment for gallstone pancreatitis treatment of pancreatitis is along with treatment of gallstones, which may involve: 

  • A procedure to relieve the blockage caused by the gallstone(s)
  • Surgical removal of the gallbladder (cholecystectomy) to prevent a recurrence

People with alcoholic pancreatitis must stop drinking alcohol to prevent pancreatitis from recurring.

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Reviewed on 8/12/2021
References
https://www.uptodate.com/contents/pancreatitis-the-basics?search=Pancreatitis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

https://www.uptodate.com/contents/acute-pancreatitis-beyond-the-basics?search=Pancreatitis&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3