Pancreatitis

If you have been experiencing abdominal pain, followed by other worrying symptoms such as nausea, vomiting, fever and weight loss—you may be suffering from a debilitating inflammation of the pancreas known as pancreatitis. 

At UCI Health, our pancreatic specialists can help restore your pancreas to health before your condition worsen.They work with you to find the best, most comprehensive treatment plan, including surgical and nonsurgical options.

Symptoms of pancreatitis

Pancreatitis is caused by inflammation of the pancreas, which causes digestive enzymes to attack the very tissues that produce them. 

Pancreatitis can be either acute or chronic. Symptoms include:

• Gradual or sudden pain in the upper abdomen that may radiate through the back and is often worse after eating
• Tender or swollen abdomen
• Nausea and vomiting
• Rapid pulse
• Fever
• Weight loss
• Diarrhea
• Oily stools

If left untreated, severe pancreatitis can cause dehydration, low blood pressure and failure of other organs, including the kidneys, resulting in bleeding, shock and death.

Causes of pancreatitis

The most common causes of acute pancreatitis are:

• Gallstones—small crystals of hardened bile—that inflame the pancreas as they pass through the common bile duct
• Chronic alcohol abuse, which can inflame the pancreas within a few hours or days after consuming alcohol
• Abdominal trauma, medications, infections, tumors and genetic abnormalities of the pancreas

The most common causes of chronic pancreatitis are:

• Years of heavy alcohol use
• Hereditary disorders of the pancreas
• Cystic fibrosis—the most common inherited disorder leading to chronic pancreatitis
• Hypercalcemia—high levels of calcium in the blood
• Hyperlipidemia or hypertriglyceridemia—high levels of blood fats
• Some medications
• Some autoimmune conditions, including autoimmune pancreatitis

Both men and women experience pancreatitis. However, your risks for developing pancreatitis are higher if you are male.

If you are under age 30, you may go undiagnosed for pancreatitis for years. If you experience episodes of abdominal pain and diarrhea lasting several days, and which come and go over time, these can progress to chronic pancreatitis. 

If you have two or more family members of different generations who have had pancreatitis, your risks of developing chronic pancreatitis are higher.

Autoimmune pancreatitis is caused by the body's immune system attacking the pancreas, and it can be mistaken for pancreatic cancer.

Diagnosis and testing for pancreatitis

Diagnosing acute pancreatitis can be difficult because of the location of the pancreas. In addition to a physical exam and blood tests, your physician may order one or more of the following tests:

• Abdominal ultrasound
• Computerized tomography (CT) scan
• Endoscopic ultrasound (EUS)
• Magnetic resonance cholangiopancreatography (MRCP)

Chronic pancreatitis is easily confused with acute pancreatitis. After a physical examination, your physician may order blood tests. In more advanced stages, your doctor may order blood, urine and stool tests to help diagnose chronic pancreatitis and monitor its progression.

Other tests include:

• X-rays
• Abdominal ultrasound
• CT, EUS and MRCP 

Treatment for pancreatitis

Treatment for acute pancreatitis

If you are diagnosed with acute pancreatitis, our physicians will prescribe a treatment of intravenous (IV) fluids, antibiotics and pain medication. You will be required to stay at the hospital for a few days during this treatment.

In severe cases, you may need to be fed a special liquid delivered by a thin tube inserted through the nose, down the throat and into the stomach.

You will be advised to avoid fatty foods, alcoholic beverages and tobacco.

If gallstones are found to be the cause of your acute pancreatitis, surgical removal of the stones and the gallbladder may be recommended.

Acute pancreatitis sometimes causes kidney failure. If you experience kidney failure, dialysis or a kidney transplant may be required.

Treatment for chronic pancreatitis

If you are diagnosed with chronic pancreatitis, treatment may require hospitalization for pain management, intravenous hydration and nutritional support. Nasogastric feedings may be necessary for several weeks if you continue to lose weight.

When a normal diet is resumed, your physician may prescribe a regimen of synthetic pancreatic enzymes and a low-fat diet consumed in small, frequent meals.

Even if chronic pancreatitis is in its early stages, you should avoid alcoholic beverages and stop smoking.

Surgical intervention may be recommended in some cases. Procedures may include:

• Distal pancreatectomy (removal of the tail of the pancreas)
• Whipple procedure (removal of the head of the pancreas)
• Peustow procedure (drainage procedure)
• Beger or Frey procedure (resection and drainage procedure)
• Total pancreatectomy (removal of the entire pancreas) with auto islet cell transplant that was developed by our team

We are the only hospital in the region that performs extracorporeal shock wave lithotripsy, a non-invasive method that uses shock waves to break down stones in the kidney.

Chronic pancreatitis also may cause diabetes, triggering the need for insulin or other medication to maintain blood glucose levels.

Why Choose UCI Health for pancreatitis

Our UCI Health hepatobiliary specialists are part of a multidisciplinary team that comprises internists, medical oncologists and surgeons, as well as highly trained nurses and other clinical professionals.

They will work with you to properly diagnose the form of your pancreatitis and its causes by conducting a comprehensive medical and genetic review, using the leading-edge technology, such as eyelid cell genetic processing conducted on site.

Following treatment, they will help you develop healthy choices that will keep your pancreas healthy and improve your quality of life, while our team of pain management specialists work with you to relieve postoperative pain.