Pancreatitis is a serious, often sudden onset condition with severe pain that requires immediate medical attention. It affects many people, yet few know its exact causes, symptoms and treatment options. As the disease can lead to serious complications, early recognition and proper treatment are key. In this post, we will take a detailed look at the most important things to know about pancreatitis so that you are aware of the background and what to do. Visit Endomedix Gastroenterology Centre with the help of experts, we explain what the condition is, what forms it takes and how it can be diagnosed and treated effectively.
What is pancreatitis?
Pancreatitis is a sudden or persistent inflammatory condition of the pancreas. The pancreas is an organ located in the upper part of the abdomen, behind the stomach, that performs two vital functions: it produces digestive enzymes to break down food and releases hormones (such as insulin) into the bloodstream to regulate blood sugar levels.
In the case of inflammation, digestive enzymes are activated while the gland is still inside the organ and start to „digest” the organ's own tissues. This process causes severe pain and tissue damage, which can even spread to surrounding organs.
Types of pancreatitis
There are two main forms of the disease:
- Acute pancreatitis: Intense inflammation that starts suddenly and usually heals completely with appropriate treatment. Most cases are mild, but serious, life-threatening complications can develop.
- Chronic pancreatitis: It is characterised by prolonged, recurrent episodes of inflammation that cause permanent damage to the pancreas. Over time, the gland becomes scarred and loses its ability to produce digestive enzymes and hormones, which can lead to indigestion and diabetes.
There are also rarer, specific forms, such as autoimmune pancreatitis, where the immune system attacks the cells of the pancreas.
What are the causes and risk factors for pancreatitis?
In the vast majority of cases, around 75%, the disease is due to two main causes:
- Bile ducts: Stones from the gallbladder into the bile duct can block the common outlet of the pancreatic duct. This leads to a build-up of enzymes and activation within the gland. This is a more common trigger in women.
- Excessive alcohol consumption: Regular, large amounts of alcohol have a direct toxic effect on the cells of the pancreas and can cause chronic inflammation, which can lead to acute flare-ups. In men, this is the most common cause.
Other possible reasons:
- High blood fat (triglycerides).
- High levels of calcium in the blood (hypercalcaemia).
- Certain medicines (e.g. certain diuretics, antibiotics, immunosuppressants).
- Injuries to the abdomen (trauma).
- Complication after ERCP (post-ERCP pancreatitis).
- Genetic predisposition.
- Autoimmune diseases.
- Viral or bacterial infections.
- Pancreatic tumours or malformations (e.g. pancreas divisum).
- Rare cases of scorpion sting.
In many cases, however, the cause remains unknown and is known as idiopathic pancreatitis.
Symptoms of pancreatitis
The symptoms of acute pancreatitis are usually dramatic and sudden.
Typical clinical signs:
- Abdominal pain: The most important symptom is a strong, penetrating pain that radiates like a belt into the back, which occurs in the region of the abdomen (epigastrium). The pain is constant and often worsens after eating. It may be relieved by bending forward.
- Nausea, vomiting: Common accompanying symptoms that do not bring relief.
- Bloating, abdominal tenderness: The abdomen can be very sensitive to touch.
- Fever: The inflammatory process can lead to fever or fever.
- Rapid pulse and breathing: A sign of a general stress reaction in the body.
- Jaundice (icterus): If gallstones cause the blockage, the skin and the whites of the eyes may become yellowish.
- Discoloration of the skin: In severe cases, there may be bluish haemorrhages around the navel (Cullen's sign) or on the lateral abdominal wall (Grey-Turner's sign), which are signs of abdominal bleeding.
The symptoms of chronic pancreatitis may be less specific. They may include recurrent abdominal pain, indigestion (fatty, foul stools, steatorrhea), involuntary weight loss and later the development of diabetes.
How is the disease diagnosed?
At least two of the following three criteria must be met for a diagnosis of acute pancreatitis:
- Characteristic, belt-like radiating pain in the upper abdomen.
- A laboratory test for blood levels of amylase and lipase enzymes at least three times the upper limit of normal. Lipase is more specific for the pancreas.
- Pancreatitis confirmed by imaging (abdominal ultrasound, CT scan).
Common diagnostic procedures:
- Laboratory tests: In addition to measuring the levels of digestive enzymes (amylase, lipase) in the blood count, it is also important to check inflammatory markers (e.g. CRP), liver and kidney function, blood glucose and calcium levels.
- Abdominal ultrasound: This is the primary imaging test used to detect gallstones, dilated bile ducts or swollen glands. However, gassy bowels can make it difficult to make an accurate assessment.
- Abdominal CT with contrast: It is used to confirm the diagnosis and to assess the extent and severity of inflammation (e.g. necrosis, necrosis), usually 72 hours after the onset of symptoms.
- MRCP (magnetic resonance cholangiopancreatography): It is suitable for detailed, non-invasive examination of the biliary and pancreatic ducts.
- Endoscopic ultrasound (EUS): It is particularly useful in identifying the cause of recurrent pancreatitis of unknown origin (e.g. small stones, mycolitis, tumours). Endomedix Gastroenterology Centre modern equipment allows this test to be carried out with high accuracy.
Treatment options
Treatment of acute pancreatitis always requires hospitalisation and is primarily about supporting the body, relieving symptoms and preventing complications.
The pillars of treatment:
- Fasting and nutritional therapy: At the start of treatment, oral feeding is suspended to relieve the pancreas. In more severe cases, early enteral (tube-feeding) improves the chances of recovery.
- Intravenous fluid replacement: Replacing fluid loss due to inflammation is key to stabilising circulation and preventing kidney damage.
- Pain relief: Effective, often narcotic painkillers are needed to relieve severe pain.
- Addressing the root cause: If gallstones are causing the inflammation, ERCP (endoscopic retrograde cholangiopancreatography) can be used to remove the stone causing the blockage. The Endomedix Gastroenterology Centre specialists are highly experienced in carrying out this intervention.
- Treatment of complications: In the case of an infected necrosis or abscess, antibiotic treatment or endoscopic or surgical intervention (drainage) may be necessary.
In chronic pancreatitis, treatment aims to relieve pain, aid digestion with artificial enzyme preparations and manage diabetes. Complete abstinence from alcohol and smoking is essential.
Complications and prevention
Pancreatitis can have serious complications, such as:
- Pseudocyst: A fluid-filled tube around the pancreas.
- Necrosis (death): Necrosis of part of the pancreatic tissue, which can easily become infected.
- Multi-organ failure: In severe cases, the inflammatory reaction can damage the lungs, kidneys and circulatory system.
- Chronic pancreatitis: Recurrent acute episodes can turn into a chronic disease.
Prevention:
- Moderate alcohol consumption: Avoiding excessive alcohol consumption is the most important prevention method.
- Healthy eating: A low-fat diet can help prevent gallstones and high triglyceride levels.
- Treatment of gallstones: If gallstones are known, timely treatment (e.g. gallbladder removal) can prevent pancreatitis from developing.
When expert help is needed
Pancreatitis is a serious condition that should be diagnosed and treated by a specialist gastroenterologist. If you experience any of the symptoms mentioned above, especially sudden onset of severe abdominal pain, you should consult a doctor immediately or go to the nearest emergency department.
From Endomedix Gastroenterology Centre has a network of highly qualified specialists and the latest diagnostic tools (e.g. endoscopic ultrasound, ERCP) for the accurate investigation and treatment of pancreatic diseases. If you have recurring abdominal complaints or suspect chronic pancreatitis, you can contact our centres for personalised care.
