Pancreatitis
Treatment Overview
Treatment of pancreatitis depends on whether you have a sudden (acute) attack of pancreatitis or you have had the condition for a long time (chronic).
Initial treatment
For acute pancreatitis: You will receive treatment in the hospital to allow the pancreas to heal. You will receive intravenous (IV) fluids to replace lost fluids and maintain your blood pressure along with medicines such as meperidine (Demerol) to control pain until the inflammation goes away.
To help rest your pancreas, you likely will not be given anything to eat for 3 to 7 days.
If gallstones are causing pancreatitis, you may have a procedure called endoscopic retrograde cholangiopancreatogram (ERCP) to remove the stones from the common bile duct. After recovering from pancreatitis, you may have surgery to remove the gallbladder
. This surgery often prevents future attacks of pancreatitis. For more information, see the Surgery section of this topic.
For chronic pancreatitis: People who have chronic pancreatitis also may have episodes of acute pancreatitis, which are treated the same as an initial episode of acute pancreatitis.
Ongoing treatment
If you have chronic pancreatitis, you may struggle with ongoing pain. Treatment for pain may include medicines to ease pain (such as Demerol) and suppress stomach acid (such as Pepcid, Zantac, Prilosec, or Prevacid).
You may need surgery to widen a narrow pancreatic duct or to remove tissue or stones that are blocking the pancreatic duct. Surgery can also drain a pseudocyst or an obstructed duct.
In advanced chronic pancreatitis, your body may not absorb fat, a condition called steatorrhea. This causes loose, oily, especially foul-smelling stools. You may lose weight as a result, because your pancreas no longer produces the enzymes you need to digest fat and protein. Pancreatic enzyme pills can replace lost enzymes.
You may need insulin if your pancreas has stopped producing enough of it.
Your health professional will want to see you every 3 to 6 months to make sure that your pain medicine is helping you and that you have not developed complications of chronic pancreatitis. Complications of chronic pancreatitis may include recurring flare-ups of symptoms, fluid buildup, bleeding, and blockage of a blood vessel, the bile duct, or the small intestine. Chronic pancreatitis also increases your risk of pancreatic cancer.
Excessive use of alcohol causes most cases of chronic pancreatitis. It is extremely important that you not drink any alcohol. Drinking even small amounts can cause severe pain and complications. Drinking large amounts of alcohol when you have chronic pancreatitis can shorten your life.5 For more information on quitting alcohol, see the topic Alcohol Abuse and Dependence.
Treatment if the condition gets worse
If acute pancreatitis is severe, you will be cared for in the intensive care unit (ICU) of the hospital, where you will receive intravenous fluids and pain medicines.
To help your pancreas heal, you will not eat. During this time, you will be nourished through enteral nutrition, in which liquid nutrients are pumped into your small intestine through a tube that is inserted in your nose. If you are not able to tolerate enteral feedings, you may receive total parenteral nutrition (TPN), in which liquid nutrients are given through a tube (catheter) that is placed in a large vein, usually in the neck or arm.
You may take medicine such as Pepcid, Zantac, Prilosec, or Prevacid to stop production of stomach acid. These medicines may help prevent the gastritis and bleeding in the stomach that may happen with pancreatitis. They do not treat pancreatitis.
In some cases, you may have a tube placed in your nose and down into your stomach to remove fluids that can irritate the pancreas. If you have to use this tube for a long time, you will receive TPN.
If your blood oxygen level is low because of respiratory complications, you may receive oxygen therapy.
If infection develops, you may need antibiotics and you might have surgery to remove the infected and dead tissue. But surgery is avoided when possible, because the pancreas is damaged easily.
You may need surgery if you develop complications from acute or chronic pancreatitis. Surgery also may be done if there is no infection and your condition has not improved.
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| Author: | Monica Rhodes | Last Updated: July 2, 2007 |
| Medical Review: | Kathleen Romito, MD - Family Medicine Brent Shoji, MD - General Surgery | |
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