Severe stomach pain? It could be acute pancreatitis

Woman holding stomach

Most people experience an unpleasant bout of indigestion now and again, but if you’re doubled over with stomach pain that’s not letting up, it may be something much more serious.

Acute pancreatitis is a condition where the pancreas suddenly becomes inflamed. In the United States, it’s one of the leading causes of hospitalization among gastrointestinal disorders. Most cases are mild, subsiding within a week, but a minority will lead to serious complications.

What are acute pancreatitis symptoms and how is it diagnosed?

The most common symptoms of acute pancreatitis are nausea and vomiting accompanied by intense pain that begins suddenly in the upper part of the abdomen and travels toward the back.

In some cases, patients may experience additional symptoms:

  • Soreness and swelling of the abdomen
  • Yellowing of the skin and/or whites of the eyes
  • Fast heartbeat (tachycardia)
  • Rapid breathing
  • Fever

What should I do after I start feeling pain?

Go to the nearest emergency department immediately. In the meantime, don’t eat or drink anything, especially anything that is high in fat. You may find that leaning forward or curling into a fetal position helps relieve the pain, while lying flat on your back makes it worse.

What causes acute pancreatitis?

The two most common causes are gallstones and alcohol consumption. When acute pancreatitis is caused by gallstones, the onset of pain usually comes after eating a large meal. If the cause is alcohol consumption, it usually comes approximately 6 to 12 hours after binge drinking. In 10-15% of cases, the cause of acute pancreatitis remains unknown.

Less common causes of acute pancreatitis include:

  • High blood fat levels
  • Certain classes of medications
  • Elevated levels of calcium in the blood
  • The immune system attacking the pancreas (autoimmune pancreatitis)
  • Viruses like measles and mumps

Can alcohol consumption increase the risk of developing acute pancreatitis?

Excessive alcohol consumption can trigger acute pancreatitis. In some cases, overuse can cause permanent damage to the pancreas, which may lead to chronic pancreatitis over time.

What role does diet play in the development of acute pancreatitis, and what foods should be avoided?

Diet plays a significant role in pancreatic health. Eating a diet that is low in animal fats and simple sugars can reduce your risk of developing the gallstones or high triglycerides that are linked to acute pancreatitis. Focus on increasing your intake of fruits, vegetables and whole grains, and limiting your intake of red and processed meat, fried and high-fat foods and processed sugar.

Is acute pancreatitis genetic or hereditary?

Acute pancreatitis is more closely linked to lifestyle and environmental factors, but genetic risk factors can play a role in some cases. In patients with hereditary chronic pancreatitis, a known condition caused by gene mutations, the first sign of the condition is usually an episode of acute pancreatitis.

Can acute pancreatitis be prevented?

Your best chance of preventing acute pancreatitis is to limit alcohol consumption and reduce the risk of gallstones by maintaining a healthy weight, eating a balanced diet, exercising and taking preventive medications as needed.

What is the prognosis for acute pancreatitis?

In approximately 80% of cases, patients will feel better on their own within a week and never have another attack. In the other 20% of cases, recovery is much more prolonged. This subset of patients who develop a more severe case may experience necrosis of the pancreas or failure of secondary organs like the kidneys, lungs or heart. Some patients may suffer from recurrent attacks throughout their lives.

What treatment is available for acute pancreatitis?

Unfortunately, treatment options for acute pancreatitis are limited. In most cases, we work to keep patients comfortable through pain control and IV hydration. Sometimes, we may intervene to remove gallstones or drain a collection of fluid. At The Ohio State University Wexner Medical Center, my colleagues and I have developed a robust research program to learn more about the causes and mechanics of acute pancreatitis. The more we learn about the condition, the closer we get to developing therapeutic treatments.

What are the best ways to manage pain associated with acute pancreatitis?

We offer patients a combination of IV fluids and pain medications (starting with NSAIDS and progressing to opioids if needed) to keep them as comfortable as possible as they recover. It is best to refrain from eating food for several days before gradually re-introducing low-fat foods in small amounts. Avoiding alcohol and smoking will also speed recovery.

What are the long-term effects of acute pancreatitis, and can it lead to chronic pancreatitis?

Repeated episodes of acute pancreatitis can damage the pancreas and lead to chronic pancreatitis. Patients also experience a higher risk of developing pancreatic cancer, chronic pain and diabetes. About a month after the initial onset of symptoms, some develop pseudocysts, which are sacs of fluid on the surface of the pancreas that can cause bloating, pain and indigestion.

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