Acute pancreatitis is inflammation of the pancreas that starts suddenly. It can cause symptoms such as abdominal swelling, abdominal pain, sweating, nausea, vomiting, loss of appetite, and diarrhea.
Acute pancreatitis mainly occurs due to excessive alcohol use or gallstones. These are among the most common causes of this condition.
Treatment for acute pancreatitis is considered a medical emergency and is typically started in the hospital. Therefore, if symptoms appear, it is important to go to the emergency room right away.
Pancreatitis symptoms
The main symptoms of acute pancreatitis are:
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Severe upper right-sided abdominal pain that starts suddenly
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Pain that may spread to the back
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Abdominal swelling
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Nausea, vomiting, and loss of appetite
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Fever above 100.4ºF (38ºC)
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Indigestion or diarrhea
In addition, excessive sweating, a fast heart rate, or yellowing of the skin and eyes may also occur.
If you develop symptoms of acute pancreatitis, you should go to the emergency department immediately so treatment can begin as soon as possible and life-threatening complications can be avoided.
Can acute pancreatitis be fatal?
Acute pancreatitis can be fatal if it is not diagnosed promptly and treated without delay. It can lead to serious complications, such as pancreatic abscess or necrosis, disseminated intravascular coagulation (DIC), and multiple organ failure.
Confirming a diagnosis
Pancreatitis is diagnosed by a healthcare provider, often in the emergency department or hospital, based on symptoms, medical history, a physical exam, and lab and imaging tests.
The doctor may order tests such as blood pancreatic enzyme (lipase) levels, triglycerides, calcium, and liver function tests (LFTs).
Imaging tests, such as an abdominal ultrasound, CT scan, or MRI, may also be ordered to assess the pancreas and identify the cause of pancreatitis and/or any complications.
Possible causes
The main causes of acute pancreatitis are:
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Excessive and frequent alcohol use
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High triglyceride levels
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Trauma or congenital malformations of the pancreas
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Autoimmune diseases
In addition, acute pancreatitis may also be caused by medications such as furosemide, enalapril, losartan, mesalamine, liraglutide, or semaglutide.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, genetic disorders of the pancreas may also increase the risk of acute pancreatitis.
Treatment options
Acute pancreatitis treatment is typically managed in the hospital by a medical team, often including a gastroenterologist, and may involve input from emergency and critical care specialists. Treatment may include:
1. Fasting
Fasting for acute pancreatitis is started as soon as the person is admitted to the hospital. This helps reduce pancreatic activity, as the pancreas plays an important role in digestion.
This measure can relieve pain in about 80% of cases. It is usually continued until abdominal pain, nausea, vomiting, and loss of appetite improve.
In more severe cases, the person may receive nutrition through a feeding tube.
2. IV fluids
According to the American Gastroenterological Association, initial treatment for acute pancreatitis includes goal-directed IV fluid therapy, which is started as soon as the person is admitted to the hospital to maintain hydration and support normal body function.
3. Medications
The doctor may prescribe pain relievers, such as acetaminophen or tramadol, as well as antibiotics, to relieve symptoms and prevent new infections.
These medications may be continued even after the person is discharged from the hospital and returns home.
If acute pancreatitis was caused by medication use, the doctor may recommend stopping that medication.
4. Surgery
Surgery for acute pancreatitis may be recommended to remove gallstones or remove the affected part of the pancreas.
In these cases, the patient may develop diabetes because the pancreas is responsible for producing insulin. Therefore, insulin injections may be needed for life.
5. Diet
A pancreatitis diet consists of fasting during the first few days of hospitalization, until symptoms are controlled with medical treatment.
After that, foods should be gradually reintroduced, prioritizing:
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Foods rich in carbohydrates and lean proteins
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Fruits, legumes, greens, and vegetables
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Water, teas, or coconut water
It is very important not to eat very fatty foods, such as fried foods, cakes, or snack foods, because these foods require enzymes produced by the pancreas to be digested properly. At this stage, the pancreas needs to rest so it can recover.