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Acute pancreatitis arises due to pancreatic inflammation leading to dysfunction. It often mimics other conditions with vague symptoms like sudden abdominal pain, frequently accompanied by nausea and/or vomiting. Distinguishing acute pancreatitis involves careful assessment of signs, symptoms, and ordering appropriate tests. Prompt treatment is crucial if diagnosed with acute pancreatitis.
Steps
Evaluating Signs and Symptoms
Communicate the nature of your abdominal pain to your doctor. Acute pancreatitis manifests with intense and sudden abdominal pain; however, differentiating it from similar conditions involves describing the specific characteristics of the pain. Indications of pancreatitis include:
- Pain spreading to your back — A primary symptom of pancreatic issues
- Pain centered in the upper middle abdomen
- Pain worsening after meals
Assess the beginning of your stomach ache. Acute pancreatitis, as its name suggests, emerges suddenly. It's a persistent pain, often akin to a stabbing sensation that intensifies post meals. If your discomfort arises gradually or persists for an extended period, it likely stems from another source.
- 'Acute pancreatitis' refers to the initial pancreatitis episodes. If the issue persists, it's termed 'chronic pancreatitis.'
- Additionally, you may experience diarrhea, particularly after consuming fatty foods. This occurs because with pancreatitis, your pancreas can't effectively process fats.
Be candid with your doctor regarding your alcohol intake. Excessive alcohol consumption ranks as the primary risk factor for pancreatitis development. Hence, honesty about your alcohol consumption frequency and quantity is crucial during discussions with your doctor.
- A history of gallstones is another significant acute pancreatitis risk factor.
- Gallstones recurrence is more likely after previous episodes, potentially triggering acute pancreatitis.
Further Examination
Undergo blood tests. If you present with acute abdominal pain at the Emergency Room or to your physician, one swift method to assess pancreas-related issues is through blood tests. Elevated pancreatic enzyme levels in your blood indicate pancreas stress, suggesting pancreatitis over other conditions.
- Elevated serum amylase and lipase levels indicate pancreatitis. Amylase and lipase, pancreatic enzymes, leak into the blood during inflammation. While elevated amylase levels can signal other stomach and liver issues, lipase is pancreas-specific.
- Additional significant results for acute pancreatitis testing include elevated C-reactive protein and interleukins.
Consider an endoscopic ultrasound (EUS). This procedure involves inserting an ultrasound probe with a camera through your esophagus, stomach, and the beginning of your small intestine to examine your pancreas closely. It offers detailed insights into pancreatic conditions, aiding in identifying the underlying cause of pancreatitis.
- An EUS also assesses the upper gastrointestinal tract, potentially revealing other causes of abdominal pain.
- Therefore, it can help rule in or out other upper GI issues contributing to your symptoms.
Undergo a CT scan. If you experience sudden abdominal pain, a CT scan may be ordered by your physician. This scan provides a comprehensive view of abdominal structures, aiding in diagnosing various medical conditions. The procedure is quick and non-invasive, typically lasting only a few minutes.
- Gallstones or pancreas inflammation may be visible on the CT scan, common indications of pancreatitis.
- Additionally, the scan can reveal generalized inflammation in the pancreas.
Managing Acute Pancreatitis
Remain hospitalized until stabilization. Due to the intensity of acute pancreatitis pain, particularly exacerbated by eating and drinking, hospitalization is often recommended for recovery. The duration varies based on the severity of the condition, with fluid replacement and pain management being the primary treatments.
Avoid oral intake during acute pancreatitis. In the initial days of hospitalization, abstaining from food and drink allows the pancreas to recuperate. Gradual reintroduction of fluids and food follows as the pancreas heals. Severe cases may necessitate a feeding tube for essential nutrients and hydration is maintained through IV fluids, with additional calories provided intravenously.
- IV fluids ensure hydration, while basic nutrients are delivered through the IV line.
Use medications for pain relief. The type and strength of pain medication prescribed by your doctor depend on the severity of your pain. Severe cases may require opioid painkillers initially, with over-the-counter options sufficient for residual pain post-discharge, if any.
Address the root cause of pancreatitis. After stabilizing your condition and managing pain, your doctor will focus on identifying and treating the underlying cause. Common treatments include:
- Gallstones — Surgical removal may be necessary, along with potential antibiotics and gallbladder removal.
- Bile duct obstructions — ERCP may be performed to address obstructions and repair damage, with surgical intervention if needed post-inflammation resolution.
- Alcohol dependence — Treatment is essential if alcohol is the culprit, including options like rehabilitation clinics or 12 Step programs.
