Abdominal pain, nausea, fever, and weakness can be challenging symptoms to deal with. These are just some of the symptoms that characterize pancreatitis. Understanding what pancreatitis is and how to treat it both are a great first steps toward managing symptoms.
Pancreatitis is an inflammation of the pancreas, a gland that’s behind the stomach in the upper part of the abdomen. When digestive enzymes in the pancreas become activated, this causes inflammation and scarring. Over 200,000 people in the United States experience pancreatitis every year.
Pancreatitis can be either acute or chronic. Symptoms of both types of pancreatitis include abdominal pain, nausea, fever, a rapid pulse, weight loss, a swollen abdomen, and diarrhea. Treatment will depend on the severity and type of pancreatitis but it often involves hospitalization. Acute pancreatitis may be treated within several days or weeks, but chronic pancreatitis may last a lifetime.
Pancreatitis happens when the pancreas becomes inflamed as digestive enzymes begin to digest pancreatic tissue. This can cause severe pain in the abdomen, nausea, and fever. Risk factors for pancreatitis include having a family history of the condition, drinking excessive amounts of alcohol, smoking, having high levels of triglycerides, trauma to the abdomen, and gallstones.
If you have symptoms of pancreatitis, your doctor will likely perform a series of tests to diagnose pancreatitis and determine what’s causing it. A blood test will show whether or not there are excessive amounts of the digestive enzymes amylase and lipase, which indicate pancreatitis.
An endoscopic retrograde cholangiopancreatography (ERCP) can show if any bile ducts are obstructed. Imaging tests like CT scans can show gallstones and inflammation in the pancreas. Even ultrasounds can help diagnose pancreatitis. The type of test a physician or gastroenterologist runs may vary depending on the person and the individual symptoms.
During a hospital stay or trip to the doctor’s office, you might be asked some of the following questions to help determine whether or not you have pancreatitis:
Acute and chronic pancreatitis will likely require different treatment methods. “Acute pancreatitis is treated with supportive care, the most important of which are controlling pain using a variety of different medications...and intravenous (IV) fluids to correct dehydration and blood work/electrolyte abnormalities,” says Taylor Graber, MD, an anesthesiologist with ASAP IVs, and the University of California, San Diego.
With severe pancreatitis, patients are not allowed to eat or drink because of increased risk of gastric obstruction and worsening pain. However, with mild pancreatitis, "the patient is encouraged to eat and drink normally, as a quicker return to normal eating can hasten recovery," explains Dr. Graber. "Most patients with mild acute pancreatitis recover within 3-7 days without further treatment or therapy. A smaller portion of patients (~20%) will develop moderate to severe pancreatitis, rarely progressing to transient and persistent organ failure, and may need further admission to an intensive care unit for monitoring and treatment.”
For people who develop chronic pancreatitis, treatment will likely involve daily doses of pain medications, vitamins, pancreatic enzymes that help digest food, and potentially insulin to help with blood sugar levels.
Antibiotics and pain medications are the most popular treatments that doctors prescribe for people with pancreatitis. The type of medication prescribed will depend on the individual, symptoms, medical history, and response to treatment.
For severe pancreatitis, antibiotics may be required to get rid of an infection in the pancreas, which is present in up to 20% of cases. Patients without an infectious etiology of pancreatitis, should not be given prophylactic antibiotics. Omnipen (ampicillin), Primaxin Iv (imipenem/cilastatin), and Rocephin (ceftriaxone sodium) are commonly prescribed for pancreatitis and require a prescription. Antibiotics may cause diarrhea, allergic reaction, or difficulty breathing.
Pancreatitis can be very painful and most people will take some form of pain medication to help with their symptoms. Some pain medications like acetaminophen (Tylenol) are available over-the-counter, and others like Demerol (meperidine hcl) and Ultram (tramadol hcl) require a prescription. Pain medications may cause side effects like dizziness, allergic reaction, or confusion. Tylenol should be avoided if there is liver damage present.
There is no one universal pancreatitis medication that’s best for everyone. Individual symptoms and responses to treatment vary. A doctor can determine the best medication for pancreatitis based on an individual’s symptoms, medical history, and response to treatments. Here’s an overview of popular medications that a doctor may prescribe.
Best medications for pancreatitis | ||||
---|---|---|---|---|
Drug name | Drug class | Administration route | Standard dosage | Common side effects |
Tylenol (acetaminophen) | Analgesic | Oral | Taken as instructed on the bottle or by a healthcare professional | Allergic reaction, yellowing of the eyes or skin, weakness/tiredness |
Ultram (tramadol hcl) | Opioid | Oral | 25 mg tablet taken every morning | Dizziness, anxiety, allergic reaction |
Demerol (meperidine hcl) | Opioid | Oral | Taken with a full glass of water as directed by a healthcare professional | Constipation, drowsiness, dry mouth |
Primaxin Iv (imipenem/cilastatin) | Antibiotic | Injection | Injection given by a healthcare professional | Allergic reaction, diarrhea, confusion |
Omnipen (ampicillin) | Antibiotic | Oral | 250–500 mg taken every 6 hours or as directed by a healthcare professional | Diarrhea, trouble breathing, swelling of the face, throat, or lips |
Rocephin (ceftriaxone sodium) | Antibiotic | Injection | Injection given by a healthcare professional | Diarrhea, allergic reaction, shortness of breath |
Dosage is determined by your doctor based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.
Common side effects of pancreatitis medications include diarrhea, trouble breathing, dizziness or lightheadedness, constipation, dry mouth, confusion, and weakness. Although it’s rare, some people may experience allergic reactions from taking medication that result in hives or difficulty breathing. Allergic reactions can be life-threatening. You should seek immediate medical care if you believe you are experiencing an allergic reaction.
This list of side effects is not comprehensive. Ask a healthcare professional for more details regarding the possible side effects of a particular medication.
Many people rely on home remedies, natural treatments, and lifestyle changes to help with their pancreatitis. Here are some popular home and natural remedies for pancreatitis:
A severe acute pancreatitis attack could be caused by many things. Excessive alcohol, smoking cigarettes, trauma to the abdomen, gallstones, and prescription medications are common causes of pancreatitis attacks.
Pancreatitis has the potential to be life-threatening, and some severe cases have been fatal. Most people recover from acute cases of pancreatitis within 3–10 days, but not getting proper treatment could lead to chronic pancreatitis, pancreatic cancer, or other health conditions like diabetes and chronic pain.
The symptoms of chronic pancreatitis can be managed or prevented, but there is no cure for the condition. People who live with chronic pancreatitis must manage symptoms for their entire lives.
It’s possible that mild cases of acute pancreatitis will go away without treatment, but untreated pancreatitis can cause other health conditions and lead to chronic pancreatitis.
People with acute pancreatitis will often spend several days in the hospital receiving intravenous fluids, pain medications, and potentially antibiotics. Treatment may vary depending on the underlying cause of acute pancreatitis. Most people go home after a few days with instructions on how to prevent further attacks and manage pain symptoms. Additional trips back to the hospital may be needed to monitor the condition.
Chronic pancreatitis is most often treated with pain medications, pancreatic enzymes, vitamins, and insulin for people who develop diabetes. Lifestyle changes may be part of a treatment plan and might include changes to diet and exercise routines. Avoiding alcohol, caffeine, and smoking are important for managing chronic pancreatitis.
There is no single medication that’s best for treating pancreatitis. A doctor may prescribe different medications based on the severity of a person’s pancreatitis and their individual symptoms. The most common medications that are used to treat pancreatitis include pain medications and antibiotics.
Many people heal from acute pancreatitis in a few days after being treated in a hospital, but it can take several weeks to heal if there are complications. Chronic pancreatitis almost never heals completely, and people with this condition have to learn to live with and manage symptoms for the entirety of their lives.
Dr. Anis Rehman is an American Board of Internal Medicine (ABIM) certified physician in Internal Medicine as well as Endocrinology, Diabetes, and Metabolism who practices in Illinois. He completed his residency at Cleveland Clinic Akron General and fellowship training at University of Cincinnati in Ohio. Dr. Rehman has several dozen research publications in reputable journals and conferences. He also enjoys traveling and landscape photography. Dr. Rehman frequently writes medical blogs for District Endocrine (districtendocrine.com) and hosts an endocrine YouTube channel, District Endocrine.
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