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.
It usually is not possible to prevent most single incident acute pancreatitis attacks or to detect them early. Recurrent acute pancreatitis may be caused by a combination of genetic risk and modifying factors, such as alcoholism. Attacks associated with alcoholism, typically involving several years of moderate to heavy alcohol consumption, are usually precipitated by an episode of binge 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 to "rest" the pancreas for several days to a few weeks until symptoms subside. People are hospitalized during this time period, and all fluids and nutrition are given intravenously (IV). Complications such as infections are monitored and treated. If the acute pancreatitis is due to gallstones, surgery may be necessary, including removal of the gallbladder.
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 affected person also may need to supplement their diet with fat-soluble vitamins and calcium. Glucose (blood sugar) is often monitored, and insulin injections may be given if the person has become diabetic. Oral diabetic medications do not usually work in these cases.
Pain control is an important part of treatment as there may have ongoing moderate to severe pain. Patients may be given narcotics and antidepressants. As time progresses and pancreas function diminishes, the pain level may drop.
Surgery may be necessary in some cases to remove all or part of the pancreas and/or to remove or bypass obstructions. It should be noted that the pancreas is very difficult to operate on.
Those with chronic pancreatitis are at a higher risk for developing pancreatic cancer. As a doctor monitors someone with chronic pancreatitis, he also will be watching for cancer.