Symptoms of Pancreatitis

Written by Huang Ya Juan
Gastroenterology
Updated on September 16, 2024
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Pancreatitis is divided into acute pancreatitis and chronic pancreatitis. Acute pancreatitis is a condition caused by various reasons that lead to damage in the pancreatic tissue. This results in the premature activation of enzymes meant for digesting food, which instead begin to digest the pancreas itself. This “self-destructive” behavior leads to a series of consequences known as acute pancreatitis. The symptoms of acute pancreatitis primarily include abdominal pain, predominantly upper abdominal pain, which occurs suddenly and is persistent, severe, or knife-like, with intermittent exacerbation; fever, nausea, vomiting frequently, with vomitus consisting of food, bile, and even blood, and the abdominal pain does not ease after vomiting; some patients may also have jaundice, often caused by gallstones or common bile duct stones inducing pancreatitis, possibly accompanied by itching of the skin. Chronic pancreatitis, on the other hand, is not necessarily caused by repeated attacks of acute pancreatitis, but rather by various causes leading to persistent inflammatory changes in the pancreas, characterized mainly by chronic and persistent inflammation, damage, and fibrosis of the pancreatic parenchyma. This can lead to irreversible morphological changes such as dilation of the pancreatic ducts, pancreatic duct stones, or calcification. Symptoms include abdominal pain, primarily upper abdominal pain, which may radiate to the back, often triggered by alcohol consumption, overeating, a high-fat diet, or fatigue; gastrointestinal symptoms include reduced appetite, bloating, and indigestion; exocrine manifestations include diarrhea, specifically steatorrhea, where the stool contains oil droplets and often has a foul odor; there may also be weight loss, emaciation, and endocrine manifestations, such as what we commonly refer to as diabetes.

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Written by Yang Chun Guang
Gastroenterology
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What department should I go to for pancreatitis?

Pancreatitis is a disease where the digestive enzymes in the pancreas are activated internally, causing the pancreas to digest itself. Clinically, it presents with upper abdominal pain, nausea, and vomiting. If severe, the abdominal pain can be intense. In such cases, one should register with the department of gastroenterology, as the pancreas is also an organ of the digestive system. If the hospital does not have a gastroenterology department, one could consider registering with the department of internal medicine. If the pancreatitis is severe and requires surgical or other treatments after examination by the gastroenterology department, further referral to another specialty for treatment may be necessary.

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Written by Wu Hai Wu
Gastroenterology
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How many days of fasting for acute pancreatitis?

The duration for which patients with acute pancreatitis must fast is determined by the severity of their condition. Some may only need to fast for a day or two, while others may require around three to four days, or even a week. In severe cases of acute pancreatitis, it might be difficult to say how long the fasting could last, potentially around two weeks. Once patients with pancreatitis start eating after a series of active treatments such as anti-infection measures, inhibiting pancreatic secretion, replenishing electrolytes, and balancing acid-base levels, and following treatments like using rhubarb to facilitate bowel movements, if their bowel movements and gas expulsion have mostly returned to normal and amylase levels have largely normalized, they can cautiously start consuming low-fat, high-vitamin, and high-calorie liquid foods.

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Principles of Treatment for Severe Pancreatitis

The treatment principles for severe pancreatitis mainly include the following points: First, closely monitor the patient's heartbeat, respiration, blood pressure, blood oxygen, etc., and if possible, transfer them to the intensive care unit. Second, maintain electrolyte balance and blood volume, and actively rehydrate. Third, enhance nutritional support, which can include parenteral nutrition outside of gastrointestinal digestion. Fourth, routinely use antibiotics in severe pancreatitis to prevent infection from necrotizing pancreatitis. Fifth, reduce the secretion of pancreatic fluid, inhibit the synthesis of pancreatic enzymes, and suppress the activity of pancreatic enzymes. If the patient develops an infection associated with pancreatic necrosis, consider surgical treatment, etc.

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Written by Wu Hai Wu
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Can I drink tea with pancreatitis?

Patients with pancreatitis are advised not to drink tea. If the symptoms are severe, they might experience intense abdominal pain, stomach coldness, fever, and cessation of gas and bowel movements. Under these conditions, patients should not drink water or eat anything, and certainly should not drink tea. The causes of pancreatitis could be biliary stone-related inflammation, excessive drinking or eating, or due to alcohol consumption. A minority of cases might be due to anatomical abnormalities of the pancreas or autoimmune diseases. Therefore, once pancreatitis occurs, it is necessary to identify the cause and take appropriate treatment measures. This includes actively suppressing the secretion of pancreatic enzymes and stomach acid, aggressively rehydrating, and, if necessary, undergoing surgical treatment.

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How to take care of acute pancreatitis

Patients with pancreatitis should pay attention to their diet during the recovery period. The basic dietary principle for pancreatitis patients is to consume small amounts of easily digestible foods, with low protein and fat content, primarily carbohydrates. During acute episodes, it's crucial to strictly control the intake of fatty foods. Once the condition has improved, patients may gradually consume protein-rich, high-vitamin, high-carbohydrate foods, along with non-irritating, easily digestible foods. Patients should avoid consuming large amounts of meat and alcohol, and can eat rice soup, lotus root starch, noodles, etc.