Pancreatitis is inflammation of the pancreas. It can be either acute, producing temporary symptoms, or chronic, leading to long-term damage.
Diagnosing the underlying cause of the inflammation is crucial in both types of pancreatitis, as unchecked inflammation may lead to long-term damage or other complications.
Pancreatitis is inflammation of the pancreas. The pancreas has important functions in the body, including making digestive enzymes and insulin. Pancreatitis occurs when the pancreatic enzymes damage the pancreatic tissue itself, causing inflammation.
This inflammation may be either temporary or long lasting.
While acute and chronic pancreatitis share a name, they are actually two different conditions.
Acute pancreatitis is the active form of pancreatitis, in which the symptoms come on suddenly. A person may experience severe stomach pain, alongside nausea and vomiting.
A blood test will reveal high levels of pancreatic enzymes.
Chronic pancreatitis is a lasting condition that may stem from repeated damage to the pancreas rather than from an acute inflammatory process. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) note that damage to the pancreas can be permanent and may worsen over time, potentially causing long-term symptoms.
The course of the condition is also different. The NIDDK state that with treatment, most people with acute pancreatitis get better in a few days.
In those with chronic pancreatitis, the symptoms may not fully subside. The condition remains present due to damage in the pancreas that does not go away.
The underlying causes are also different for both types. There are many possible causes of pancreatitis.
Common causes of chronic pancreatitis are heavy alcohol use and genetic disorders.
Other causes of both types of pancreatitis may include:
- reactions to some medicines
- complications from infections
- complications from surgery
- pancreatic cancer
- injury to the abdomen
- a condition called pancreas divisum
Both acute and chronic pancreatitis can sometimes be idiopathic, which means that doctors cannot identify an underlying cause.
Pain may be another differentiating factor for acute and chronic pancreatitis.
Acute pancreatitis is generally temporary, and the person will often fully recover within a few days. On the other hand, pain from chronic pancreatitis may come and go or be consistent for months at a time.
While they are different issues, acute pancreatitis may also be a risk factor for chronic pancreatitis.
Research from 2018 notes that about 20% of people with acute pancreatitis have a recurrence of the issue. Of these individuals, about 36% will go on to develop chronic pancreatitis.
Chronic pancreatitis has numerous other risk factors, including:
Acute pancreatitis causes a sudden bout of active inflammation in the pancreas. This inflammation may cause a few symptoms, such as:
- stomach pain
- pain that comes on suddenly or intensifies quickly
- pain that radiates from the abdomen to the back
- pain that gets worse after a meal
- a tender, swollen abdomen
- fast resting heart rate
The symptoms are generally uncomfortable enough for the person to seek medical attention. Doctors will perform blood tests, which will reveal high levels of pancreatic enzymes in the person’s blood.
Chronic pancreatitis may produce symptoms similar to those of acute pancreatitis, but it has distinct symptoms and risks.
Chronic pancreatitis causes constant or regular bouts of stomach pain. This pain may not go away completely, or it may come and go.
Other symptoms may include:
- pain that gets worse after a meal
- nausea or vomiting
- excessive thirst
- changes in skin color
- unintentional weight loss
- greasy or oily stools
- fibrosis or scarring on the pancreas
The condition can also make diabetes more difficult to manage.
Diagnosing acute or chronic pancreatitis involves analyzing the person’s symptoms via tests and eliminating other possible causes.
Doctors will carry out a physical exam to look for signs of trauma or other abdominal symptoms. They will ask the person about their medical history and any lifestyle choices that may affect the organs, such as drinking or smoking.
They will also order blood work to check for high levels of pancreatic enzymes. If the results of these tests are inconclusive, doctors may order imaging tests, such as a CT scan or ultrasound, to look at the pancreas itself or the organs around it.
In cases of chronic pancreatitis, doctors use various imaging tests, such as CT scans, MRIs, and ultrasounds, to check the pancreas.
Chronic pancreatitis may produce telling symptoms, such as constant or regular stomach pain, diabetes that is difficult to control, and oily or greasy stools. Doctors are likely to ask about or test for these factors before confirming a diagnosis.
Pain management is important in treating both acute and chronic pancreatitis. Doctors will give the person medications to control pain while carrying out the diagnosis and developing a proper treatment plan.
Treatment for both forms of pancreatitis may include intravenous (IV) fluids, which prevent dehydration and provide nutrition if the person cannot eat or swallow. Some people may require antibiotics or other medications.
Those with acute pancreatitis may also need other forms of treatment, depending on the underlying cause. In cases where gallstones cause symptoms, doctors may recommend surgery to remove the gallbladder.
Other procedures may be necessary, such as processes to drain fluids from abscesses or remove damaged parts of the pancreas itself.
For acute pancreatitis, the NIDDK note that symptoms may subside within a few days with treatment. Even in mild cases, it is important to see a doctor for a thorough diagnosis of the underlying cause.
Treatment for chronic pancreatitis involves controlling the symptoms and complications. The inflammation and damage from chronic pancreatitis are irreversible, and the pancreas does not heal over time.
Treatment may sometimes include surgery to remove pancreatic stones or other blockages.
Other treatments may include:
- treatment for diabetes
- nutritional supplements and vitamins
- enzyme tablets
- other procedures, such as nerve blockers
With proper treatment, many people can maintain their quality of life.
Anyone experiencing severe stomach pain should call their doctor or seek immediate medical attention. A quick diagnosis is important in each case to begin any possible treatments.
Controlling damage from acute pancreatitis is important to reduce the chance of complications. Although it is not possible to reverse the damage or inflammation that chronic pancreatitis causes, regular treatment is important to help control other complications and help the person get relief from the symptoms.