Download Pancreatitis - Capital Health

2014
Pancreatitis
Pancreatitis
What is the pancreas?
The pancreas is a flat-shaped gland that lies behind
your stomach.
Pancreas
What does the pancreas do?
• The pancreas makes the enzymes that are needed
to digest the fats, proteins, and carbohydrates
we eat. A duct (tube) that runs the length of the
gland delivers the enzymes to the duodenum (the
beginning of the small bowel).
• There are special cells, the islets of the pancreas,
which secrete insulin and glucagon into the
bloodstream. They control your blood sugar level.
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What is pancreatitis?
The term ‘pancreatitis’ means inflammation of
the pancreas. There are 2 types of pancreatitis,
acute and chronic.
Chronic pancreatitis
This is a long-term condition that causes scarring
and permanent damage to the pancreas. The main
symptoms are pain, weight loss, and loss of pancreas
tissue (possibly causing diabetes and poor nutrition).
Acute pancreatitis
This is when there is a sudden onset of symptoms
and it is the most common type of pancreatitis.
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Acute Pancreatitis
What causes acute pancreatitis?
The most common cause in adults is gallstones.
Alcohol abuse is next. You may have more than one
attack but usually recover fully after each one.
Less common causes of acute pancreatitis
are:
• A viral infection
• An accident or physical injury
• Handling of the pancreas at the time of
surgery or ERCP (Endoscopic retrograde
cholangiopancreatography procedure)
• Some medications
• Elevated blood triglyceride levels
• A defect (physical problem) in the structure of
pancreas or intestine
In about 15% of cases the cause is unknown.
In pancreatitis, the enzymes that are normally
secreted for food digestion can attack the pancreas.
This is called autodigestion. There may be bleeding
into the pancreas causing swelling, serious tissue
damage, infections, and cysts. In severe cases, the
enzymes and toxins may enter the blood stream and
seriously injure organs such as the heart, lungs, and
kidneys. Intense, painful symptoms may last for
hours to days. About 20% of cases are severe.
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What are the symptoms of acute pancreatitis?
The main symptoms are pain in the upper abdomen
or back, and nausea.
Acute pancreatitis comes on suddenly. It can vary
from mild to life-threatening.
It usually goes away in a week or so. Severe cases
may have major complications such as infection,
hemorrhage (heavy bleeding), failure of other organs,
or fluid collections in the abdomen (called pseudo
cysts). The pseudo cysts often go away on their
own. Large cysts that last for more than 6 weeks are
usually drained to prevent further problems.
How is acute pancreatitis diagnosed?
• Your doctor will find that the abdomen is tender.
• During acute attacks, high levels of amylase and
lipase are found in the blood. Amylase and lipase
are digestive enzymes made in the pancreas.
• A CT scan or ultrasound may show swelling or
damage to the pancreas, or fluid collecting around
the pancreas.
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What is the treatment for acute pancreatitis?
• You may need to stay in the hospital to treat the
vomiting and pain with intravenous (IV) fluids,
electrolytes, and pain medication.
• Tests will be needed to find the cause of the
pancreatitis. If the pancreatitis is due to
gallstones, your doctor will recommend removing
your gallbladder.
• You will be watched closely for complications.
• Patients with severe symptoms may need care in
an Intensive Care Unit (ICU) or an Intermediate
Care Unit (IMCU).
• Surgery may be needed if a pancreatic infection
develops.
In most cases, your symptoms will go away in 4-7
days. Around then, you can start to drink fluids on
your own and be discharged from hospital.
Can acute pancreatitis be prevented?
In most cases, the answer is no.
Precautions to avoid some types of pancreatitis:
• Avoid alcohol.
• If you have diabetes or high cholesterol, follow
your treatment plan.
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Chronic Pancreatitis
What causes chronic pancreatitis?
Alcohol abuse causes 75% of chronic pancreatitis.
Less common causes are:
• Hereditary (passed down in families) pancreatitis
• Obstruction (blockage) of the pancreatic duct
In many cases, it is not possible to be sure of the
cause.
There is always irreversible scarring of the duct
and of the function of the glandular tissue in the
pancreas.
What are the symptoms of chronic
pancreatitis?
The main symptom is pain. The pain is usually in
the upper abdomen, and often spreads to the back.
Attacks of pain last from hours to days, and may
become continuous. Eating may increase the pain.
There may be weight loss and foul (bad)-smelling
bowel movements (stools).
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How is chronic pancreatitis diagnosed?
• There is often a history of pancreatitis.
• There may be signs of poor nutrition and weight
loss.
• An abnormal CT scan or ultrasound may show
inflammation and/or hardening of the pancreas.
• Amylase levels may be elevated (higher).
• A number of special tests are available to
assess the function of the pancreas and enzyme
secretion.
How is chronic pancreatitis treated?
• If a cause is found, it should be treated.
• Stop drinking alcohol completely.
• Pain relief is important. Referral to a chronic pain
clinic may be helpful to find treatment options
other than narcotics.
• A low-fat diet should be followed. Take fat-soluble
vitamins (A, D, and K) and calcium.
• If you have pancreatic insufficiency, you may
receive enzyme replacement.
• If you develop diabetes, you may need insulin
injections.
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Are there any complications with chronic
pancreatitis?
Possible complications are:
• Narcotic addiction
• Obstruction (blockage) of the common bile duct
• Pancreatic insufficiency
• Diabetes
What are the consequences of chronic
pancreatitis?
• Hospital stays
• Social life and employment may be affected
• Weight loss
• Depression
• Narcotic dependency if narcotics are needed for
pain
A variety of health care providers are often needed to
manage your disorder.
We hope we have explained what can and cannot be
done for this condition. You will be able to work with
your health care team to choose the best treatments
for you.
If you have any questions, please ask.
We are here to help you.
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Notes:
Looking for more health information?
Contact your local public library for books, videos, magazines, and other resources.
For more information go to http://library.novascotia.ca
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Please do not use perfumed products. Thank you!
Capital Health, Nova Scotia
www.cdha.nshealth.ca
Prepared by: Eleanor Griffiths RN, BScN, Nurse Educator
Revised by: Clinical Nurse Educator, Hepatobiliary Surgery
Illustration by: LifeART Super Anatomy 1 Images, Copyright © 1994, TechPool Studios Corp. USA
Designed by: Capital Health Library Services, Patient Education Team
Printed by: Dalhousie University Print Centre
The information in this brochure is provided for informational and educational purposes only.
The information is not intended to be and does not constitute healthcare or medical advice.
If you have any questions, please ask your healthcare provider.
WI85-1071 Revised September 2014
The information in this pamphlet is to be updated every 3 years.