Gallstones and alcohol are the two main causes of acute pancreatitis. With chronic pancreatitis, it’s been estimated that up to 55 percent of cases in the United States are due to heavy drinking or alcoholism. (1)
Where Is the Pain of Pancreatitis Felt?
The most common symptom of both acute and chronic pancreatitis is pain in the upper abdominal area, usually under the ribs. This pain:
May be mild at first and get worse after eating or drinkingMay become constant, severe, and last for several daysTends to worsen while lying down on the back and lessen while leaning forward in a sitting positionOften radiates throughout the backIs not aggravated by movementIs not dull or located in the lower abdominal area
The abdominal pain may also differ depending on the cause of the pancreatitis. The pain of gallstone pancreatitis, for instance, is usually sudden, stabbing, and may radiate to the back. The pain of alcoholic pancreatitis, on the other hand, may develop more slowly and be less localized.
Other Symptoms of Acute Pancreatitis
In addition to abdominal pain, nausea and vomiting are hallmark symptoms of acute pancreatitis. The stress on various systems can also cause those with the condition to appear as ill as they are. They may look pale, sweaty, and in distress. Other symptoms include:
FeverJaundice (yellowing of the skin and eyes)Rapid pulseSwollen or tender abdomenBloatingHiccupsIndigestionClay-colored stools
Because pancreatitis causes a drop in your digestive enzyme supply, you can’t sufficiently break down food. When you can’t sufficiently break down food, it isn’t absorbed as it needs to be, and this is what creates a change in the nature of stools. This difficulty absorbing food and its nutrients can lead to weight loss as well. RELATED: Here’s What May Be Causing Your Digestive Gas Pain
Symptoms of Chronic Pancreatitis
Symptoms of chronic pancreatitis often manifest themselves only when complications arise or the condition worsens. The pain of chronic pancreatitis takes two forms. In the first kind, the pain may come and go, flaring up for several hours or several weeks, with no discomfort in between flare-ups. In the second, the pain is steady and debilitating. In some cases, those with this form of pancreatic may feel pain in parts of the body other than the abdomen. There may sometimes be no pain at all. Some of the defining symptoms of chronic pancreatitis include:
DiarrheaNauseaVomitingWeight lossOily stools
What Is Severe Pancreatitis?
Acute pancreatitis is classified as mild, moderate, or severe. Whereas mild or moderate pancreatitis lasts for days, severe pancreatitis can last for a number of weeks. Severe pancreatitis, which occurs in 15 to 20 percent of acute pancreatitis cases, can lead to multiple complications. (2) The first stage of severe pancreatitis is marked by organ failure that doesn’t subside on its own within 48 hours. Scientists are still not sure exactly how this organ failure occurs, but they think that pancreatitis, being an inflammatory condition, sets off a chain reaction of inflammation that damages and compromises the systems related to or near the pancreas. The lungs are affected first. Inflammation causes surrounding blood vessels to leak into the air sacs, and the fluid in the lungs makes it hard to breathe. Respiratory problems caused by organ failure are the most frequent complications of acute pancreatitis. (3) If organ failure is treated within a few days, the risk of dying is low. It’s been estimated that if the organ failure persists for a week or more, there is a 1 in 3 chance of dying. (4) In severe pancreatitis, the tissues in the pancreas die — this is called pancreatic necrosis — and often become infected. This complication occurs after organ failure has been detected. To prevent the further spread of infection, the dead tissue is frequently removed. It is possible to have severe pancreatitis with necrosis but without organ failure. Other complications of severe pancreatitis include:
Hemorrhaging (bleeding)Obstruction of the common bile ductPeritonitis, an inflammation of the tissue that lines the inner wall of the abdomen (the peritoneum)Rupturing of the pancreatic ductAcute respiratory distress syndrome (ARDS)Acute lung injury
RELATED: Exocrine Pancreatic Insufficiency: A Complication of Pancreatitis You Should Know About
What Are Other Complications Associated With Pancreatitis?
These are some of the other complications that may develop as a result of acute, severe, or chronic pancreatitis:
Low blood pressureDehydrationBreathing problems due to hormone changes that affect lung functionMalnutrition due to the inefficient breakdown and absorption of foodPancreatic pseudocysts, or fluid and debris-filled sacs, which may cause bleeding and infection if they ruptureExtra-pancreatic (outside of the pancreas) infections, including pneumonia, bloodstream infections, and urinary tract infectionsDiabetes
Since your body is using its fluids to help fight the injuries to your pancreas, you may become dehydrated. Vomiting and the inability to eat may also contribute to dehydration, and it may also lead to low blood pressure.
How Is Pancreatitis Diagnosed?
As with most diseases, diagnosis of pancreatitis often begins with a medical history review and a physical examination. Your doctor will also order a blood test and, possibly, one or more imaging tests, such as:
Magnetic resonance imaging (MRI) scan, particularly magnetic resonance cholangiopancreatography, which visualizes the biliary and pancreatic ductsComputerized tomography (CT) scanAbdominal ultrasoundEndoscopic ultrasound, which involves a long, thin tube that’s inserted into the small intestine through the throatEndoscopic retrograde cholangiopancreatography (ERCP), a procedure that uses an endoscope to help X-ray the bile and pancreatic ductsMagnetic resonance cholangiopancreatography (MRCP)
To be diagnosed with pancreatitis, you need to have at least two of the following symptoms:
Abdominal pain associated with pancreatitisBlood test results showing you have levels of the pancreatic enzymes amylase or lipase that are at least three times the normal amountAbdominal images showing changes that are characteristic of pancreatitis
Additional reporting by Carlene Bauer.
