What Is Acute Pancreatitis?

Acute pancreatitis is a condition that causes inflammation of the pancreas—an organ located behind the stomach. The two main functions of the pancreas are to produce hormones and digestive enzymes that help you process the food you eat. Pancreatitis develops when these enzymes become damaged and cause your pancreas to become inflamed. As a result, it's common to experience symptoms like abdominal pain or nausea.

In most cases, acute pancreatitis goes away within a few days with treatment. But in rare cases, the condition can become severe and require hospitalization. Acute pancreatitis leads to approximately 275,000 hospitalizations in the U.S. each year. Gallstones and excessive use of alcohol are the two most common causes of this condition. If you're experiencing symptoms, it's a good idea to reach out to your healthcare provider. If left untreated, this condition can cause serious complications and sometimes become fatal.

Types of Acute Pancreatitis

Based on the Atlanta Classification, there are two types of acute pancreatitis:

• Interstitial edematous acute pancreatitis: Happens when the tissue surrounding your pancreas becomes inflamed
• Necrotizing acute pancreatitis: Occurs when the tissue surrounding your pancreas dies due to disease, injury, or lack of blood flow

Symptoms

The most common symptom of acute (or, short-term) pancreatitis is abdominal pain in the upper part of your torso. The pain may worsen while lying flat on your back or after you eat foods that are high in fat. In some cases, the pain can become severe and spread to your back.

Other symptoms of acute pancreatitis include:

• Nausea and vomiting
• Fever
• Bloating
• Indigestion
• Increased heartbeat
• Abdominal swelling

Causes

The two most common causes of acute pancreatitis are gallstones and excess alcohol use. Gallstones are hard substances that form when substances like cholesterol or bilirubin build up in the gallbladder. When gallstones travel through your bile and pancreatic ducts, they can get stuck and blow your ducts. As a result, inflammation of the pancreas can occur and increase your risk of acute pancreatitis.

Additionally, drinking excessive alcohol can damage the functioning of your pancreas. Generally, excessive means more than 3 drinks per day for 5 years or more. Excess alcohol intake can damage the pancreas and eventually lead to acute pancreatitis.

Other common causes of acute pancreatitis include:

• Medications, such as corticosteroids, thiazides, and sulfonamides
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Trauma or damage to the pancreas due to surgery or injury
• Genetic disorders such as alpha 1-antitrypsin deficiency and cystic fibrosis
• Infections with bacteria, viruses, parasites, or fungi
  
• High triglyceride and calcium levels in the blood
• Tumors

Diagnosis

If you're experiencing symptoms of acute pancreatitis, it's important to seek care from your healthcare provider. During your appointment, they will ask about your symptoms, review your medical history, and perform a physical exam to detect any pain or swelling in the abdomen.

Your provider may then recommend a few tests to confirm the diagnosis. These exams include:

• Blood tests: Check for levels of amylase, lipase, glucose, and blood fats in your blood. High levels of these substances can indicate acute pancreatitis or other pancreatic infections.
• Ultrasound: Uses high-frequency waves to create an image of your internal organs and their structures, which can be effective in detecting the presence of gallstones.
• Computed tomography (CT) scan: Involves the use of X-rays to create images of the pancreas and bile ducts, which can help detect signs of acute pancreatitis or pancreatic cancer.
• Endoscopic ultrasound: Inserts a thin flexible tube-looking device (called an endoscope) through your mouth to the small intestine. The device also comes with an ultrasound attachment that helps create images of the inside of your pancreas and determine any abnormalities with the organ.
• Magnetic resonance cholangiopancreatography (MRCP): Creates images of your internal organs and soft tissues to detect signs of acute pancreatitis.
• Pancreatic function test (PFT): Detects how well your pancreas responds to a hormone called secretin (which is made by the small intestine) to check the overall functioning and health of your pancreas.

Treatment

If you have acute pancreatitis, your healthcare provider will recommend a treatment plan based on the severity of your condition. Mild acute pancreatitis most often goes away on its own with a few days of rest and treatment. However, severe cases of acute pancreatitis may require hospital admission for treatment.

Common treatment options for acute pancreatitis include:

• Intravenous fluids (through an IV) to prevent dehydration and restore blood volume
• Medications such as non-steroidal anti-inflammatory drugs to reduce abdominal pain
• Eating a low-fat diet or using a feeding tube to give you food if your body isn't able to digest meals properly
• Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure used to identify and remove a gallstone stuck in the common bile duct that can be causing gallstone pancreatitis.
• Surgery to remove damaged tissue or the gallbladder if your pancreatitis is being caused by a blockage of the bile or pancreatic ducts

If your symptoms are due to bacterial or viral infections or high levels of triglycerides and calcium in the blood, your provider can also prescribe medications to help manage these conditions.

Prevention

Acute pancreatitis can be extremely painful. Fortunately, you can prevent this condition by implementing these lifestyle changes::

• Quitting smoking
• Limiting alcohol use
  
• Eating a nutritious and balanced diet
• Exercising regularly
• Managing obesity

Complications

It's essential to get treatment for acute pancreatitis. If left untreated, the condition can lead to serious complications, such as:

• Pseudocysts: Fluid-filled sacs that occur due to fluid collection in the pancreas. They may also comprise pancreatic tissues, blood, and enzymes.
• Pancreatic necrosis: The death of pancreatic tissues due to damage or injury. In some cases, the tissues may get infected leading to severe body-wide symptoms and even death.
• Pancreatic abscess: These abscesses are a collection of pus within the pancreas, which can form after four weeks of developing acute pancreatitis. This condition often develops due to an infection in pseudocysts.
• Abdominal compartment syndrome: A severe complication of acute pancreatitis where the abdominal pressure increases above 20 mmHg (which is very high). High pressure can cause multiple organ failure and lead to death.
• Chronic pancreatitis: If left untreated, acute pancreatitis can develop into chronic (or, long-term) pancreatitis that may cause irreversible damage to the pancreas.

Living with Acute Pancreatitis

Acute pancreatitis usually resolves within a week or less with treatment. However, in some cases, it may be severe and lead to hospitalization, which may require longer treatment. Several treatment options are available for improving symptoms and treating the condition. These include medications, fluids from an IV, and surgery. Taking the recommended medications and following any lifestyle adjustments your provider recommends can help reduce symptoms and prevent future episodes.