Prevention, Early Detection, and Treatment
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.
Acute Pancreatitis
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 and fasting and "resting" the pancreas for several days to a few weeks until symptoms subside. Patients are hospitalized during this time period, and all fluids and nutrition are given intravenously (IVs). Complications are monitored and treated as they occur, such as with antibiotics for infection. If the acute pancreatitis is due to gallstones, surgery may be necessary to remove the gallbladder.
Chronic Pancreatitis
Chronic pancreatitis is treated by trying to prevent future attacks, minimizing pancreatic damage, and by addressing damage already done. Abstention from alcohol is critical in helping to prevent additional attacks. A low fat diet may be prescribed to reduce the burden on the pancreas and pancreatic enzymes may be given to alleviate insufficiencies and malabsorption. The patient also may need to supplement fat-soluble vitamins and calcium. Glucose (blood sugar) is often monitored, and insulin injections may be given if the patient has become diabetic (oral diabetic medications do 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 antidepressants. Their nerves may be injected with alcohol to prevent them from transmitting pain and, in some cases, the nerves may be surgically cut. 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. As your doctor monitors your chronic pancreatitis, he also will be watching for cancer.
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