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Pancreatitis demands prompt medical attention. During an acute attack, there is the potential for the pancreas to be destroyed within a matter of hours and complications can be life-threatening.
It usually is not possible to prevent most single incident acute pancreatitis attacks or to detect them early. If it is due to established alcoholism (it usually takes several years of moderate to heavy alcohol consumption to lead to this point), the attack is usually precipitated by an episode of binge drinking. While the acute attack may not have been preventable (given that the patient is still drinking), there may or may not have been earlier warning pains that could have been addressed by seeking medical attention. In the case of gallstones or other causes of acute pancreatitis, there usually is no warning before the attack.
Treatment usually consists of pain control, intravenous fluids and fasting and ‘resting’ the pancreas for several days to a few weeks until symptoms subside. Patients are hospitalised during this time period and all fluids and nutrition are given intravenously (IV). Complications are monitored and treated as they occur, such as with antibiotics for infection or with low calcium levels. If the acute pancreatitis is due to gallstones, ERCP may be required to remove the gallstone and surgery may be necessary to remove the gallbladder following the bout of acute pancreatitis to prevent reocurrence.
Chronic pancreatitis is treated by trying to prevent future attacks, minimising pancreatic damage, and by addressing damage already done. Cessation of alcohol is critical in helping to prevent additional attacks. Cessation of smoking is also important. A low fat diet and small meal sizes may be prescribed to reduce the burden on the pancreas and pancreatic enzyme supplements may be given by mouth to alleviate insufficiencies and reduce malabsorption. The patient also may need to supplement fat-soluble vitamins (vitamins A, D, E and K) and calcium. Glucose (blood sugar) is often monitored, and insulin injections may be given if the patient has become diabetic (treatment with tablets does not usually work in these cases).
Pain control is an important part of treatment as patients may have ongoing moderate to severe pain. Patients may be given narcotics and medications to control nerve pain. As time progresses and pancreas function diminishes, the pain level may drop.
Surgery may be necessary in some cases to remove part or all of the pancreas and/or to remove or bypass obstructions. It should be noted that the pancreas is very difficult to operate on and requires a surgeon experienced in pancreatic surgery.
Those with chronic pancreatitis are at a higher risk for developing pancreatic cancer.
Last Review Date: September 5, 2017