The nurse should monitor the client with acute pancreatitis for which of the following complications

Treatment for acute or chronic pancreatitis may include

• a hospital stay to treat dehydration with intravenous (IV) fluids and, if you can swallow them, fluids by mouth
• pain medicine, and antibiotics by mouth or through an IV if you have an infection in your pancreas
• a low-fat diet, or nutrition by feeding tube or IV if you can’t eat

Your doctor may send you to a gastroenterologist or surgeon for one of the following treatments, depending on the type of pancreatitis that you have.

Acute pancreatitis

Mild acute pancreatitis usually goes away in a few days with rest and treatment. If your pancreatitis is more severe, your treatment may also include:

Surgery. Your doctor may recommend surgery to remove the gallbladder, called cholecystectomy, if gallstones cause your pancreatitis. Having surgery within a few days after you are admitted to the hospital lowers the chance of complications. If you have severe pancreatitis, your doctor may advise delaying surgery to first treat complications.

Procedures. Your doctor or specialist will drain fluid in your abdomen if you have an abscess or infected pseudocyst, or a large pseudocyst causing pain or bleeding. Your doctor may remove damaged tissue from your pancreas.

Endoscopic Cholangiopancreatography (ERCP). Doctors use ERCP to treat both acute and chronic pancreatitis. ERCP combines upper gastrointestinal endoscopy and x-rays to treat narrowing or blockage of a bile or pancreatic duct. Your gastroenterologist may use ERCP to remove gallstones blocking the bile or pancreatic ducts.

Chronic pancreatitis

Treatment for chronic pancreatitis may help relieve pain, improve how well the pancreas works, and manage complications.

Your doctor may prescribe or provide the following:

Medicines and vitamins. Your doctor may give you enzyme pills to help with digestion, or vitamins A, D, E, and K if you have malabsorption. He or she may also give you vitamin B-12 shots if you need them.

Treatment for diabetes. Chronic pancreatitis may cause diabetes. If you get diabetes, your doctor and health care team will work with you to create an eating plan and a routine of medicine, blood glucose monitoring, and regular checkups.

Surgery. Your doctor may recommend surgery to relieve pressure or blockage in your pancreatic duct, or to remove a damaged or infected part of your pancreas. Surgery is done in a hospital, where you may have to stay a few days.

In patients who do not get better with other treatments, surgeons may perform surgery to remove your whole pancreas, followed by islet auto-transplantation. Islets are groups of cells in your pancreas that make hormones, including insulin. After removing your pancreas, doctors will take islets from your pancreas and transplant them into your liver. The islets will begin to make hormones and release them into your bloodstream.

Procedures. Your doctor may suggest a nerve block, which is a shot of numbing medicine through your skin and directly into nerves that carry the pain message from your pancreas. If you have stones blocking your pancreatic duct, your doctor may use a procedure to break up and remove the stones.

How can I help manage my pancreatitis?

Stop drinking alcohol

Health care professionals strongly advise people with pancreatitis to stop drinking alcohol, even if your pancreatitis is mild or in the early stages. Continuing to drink alcohol when you have acute pancreatitis can lead to

• more episodes of acute pancreatitis
• chronic pancreatitis

When people with chronic pancreatitis caused by alcohol use continue to drink alcohol, the condition is more likely to lead to severe complications and even death.

Talk with your health care professional if you need help to stop drinking alcohol.

Stop smoking

Health care professionals strongly advise people with pancreatitis to stop smoking, even if your pancreatitis is mild or in the early stages. Smoking with acute pancreatitis, especially if it’s caused by alcohol use, greatly raises the chances that your pancreatitis will become chronic. Smoking with pancreatitis also may raise your risk of pancreatic cancer.

Talk with your health care professional if you need help to stop smoking.

How can I help prevent pancreatitis?

You can’t prevent pancreatitis, but you can take steps to help you stay healthy.

Maintain a healthy weight or lose weight safely

Maintaining a healthy lifestyle and a healthy weight—or losing weight if needed—can help to

• make your pancreas work better
• lower your chance of getting gallstones, a leading cause of pancreatitis
• prevent obesity—a risk factor for pancreatitis
• prevent diabetes—a risk factor for pancreatitis

Avoid alcohol use

Alcohol use can cause acute and chronic pancreatitis. Talk with your health care professional if you need help to stop drinking alcohol.

Avoid smoking

Smoking is a common risk factor for pancreatitis—and the chances of getting pancreatitis are even higher in people who smoke and drink alcohol. Talk with your health care professional if you need help to stop smoking.

ABOUT CAUSES DIAGNOSIS TREATMENT NEXT STEPS

Your pancreas is an organ with many important functions. It makes enzymes that help you digest food. It also makes insulin to keep your blood sugar levels under control.

Short-term (acute) pancreatitis is a sudden inflammation of your pancreas. This can be very painful. You may have nausea, vomiting, and fever. If your acute pancreatitis doesn’t get better and slowly gets worse, you may have chronic pancreatitis.

If you have chronic pancreatitis, the digestive enzymes that would normally travel by tubes inside your pancreas and empty into your upper intestine, become trapped inside your pancreas. This causes pain and scarring. The trapped enzymes slowly cause severe damage to your pancreas.

The most common cause of chronic pancreatitis is drinking a lot of alcohol over a long period of time.. Other causes include:

• An attack of acute pancreatitis that damages your pancreatic ducts
• A blockage of the main pancreatic duct caused by cancer 
• Certain autoimmune disorders
• Cystic fibrosis
• Hereditary diseases of the pancreas
• Smoking
• Unknown cause in some cases

Early symptoms of chronic pancreatitis are similar to acute pancreatitis. Symptoms are occasional and include:

• Pain in the upper belly that spreads into the back
• Pain in the belly that gets worse when you eat or drink alcohol
• Diarrhea or oily stools
• Nausea and vomiting
• Severe belly (abdominal) pain that may be constant or that comes back
• Weight loss

Chronic pancreatitis causes severe damage to your pancreas. This means that your body won't be able to make needed enzymes and hormones. This can result in malnutrition, because you won't be able to digest foods. Chronic pancreatitis can also cause diabetes. This happens because your pancreas can't make insulin. Insulin controls blood sugar.

Your healthcare provider will diagnose you with chronic pancreatitis if:

• You have a history of acute pancreatitis that comes back or doesn’t get better 
• You have symptoms of chronic pancreatitis

Your healthcare provider will examine your belly. You will also be asked about your drinking history and any family history of pancreatic disease or cystic fibrosis. Blood and imaging tests are an important part of your diagnosis. They can include:

• Blood tests.  They will look for high levels of two pancreatic enzymes, amylase and lipase. These may spill into your blood. Other tests may show blockage or damage of your gallbladder. They can also be used to check for certain inherited conditions. You may need vitamin levels and other lab tests.
• CT scan. This test creates a 3-D image of your pancreas, using X-rays and a computer.
• Abdominal ultrasound. This test uses sound waves to create an image of your pancreas.
• Endoscopic ultrasound. This test uses a long, thin tube (endoscope) that is put through your mouth and into your stomach and upper intestine. An ultrasound on the scope makes images of the pancreas and gallbladder ducts.
• ERCP. This test uses a long, thin tube (endoscope) that is put into the pancreas drainage area if treatment needs to be done.
• Magnetic resonance cholangiopancreatography. This test makes images using radio waves, a strong magnet, and a computer. In some MRI tests, you will need to have dye injected to show a more detailed image of your pancreas and the ducts of your gallbladder.

Day-to-day treatment includes: 

• Pain medicine
• Pancreatic enzyme supplements with every meal
• Insulin, if you develop diabetes
• Vitamin supplements, if needed

For acute pancreatitis or a flare-up, you may need to stay in the hospital for treatment. Your exact treatment will depend on the cause of your chronic pancreatitis, how severe the symptoms are, and your physical condition. Acute treatments may include:

• Feeding through a tube through the nose into the stomach
• Fasting
• IV fluids
• Pain medicines

Chronic pancreatitis damages the insulin-producing cells of the pancreas. This may cause these complications: 

• Calcification of the pancreas. This means the pancreatic tissue hardens from deposits of calcium salts.
• Long-term (chronic) pain
• Diabetes
• Gallstones
• Kidney failure
• Buildup of fluid and tissue debris (pseudocysts)
• Pancreatic cancer
• Acute flare-ups that keep coming back

The best way to prevent chronic pancreatitis is to drink only in moderation or not at all. Moderate alcohol drinking is considered to be no more than 1 drink per day for women and 2 drinks per day for men. Quitting smoking is also very helpful. It eases pain and swelling.

If you have been diagnosed with chronic pancreatitis, your healthcare provider may suggest these lifestyle changes:

• Don’t drink alcoholic drinks.
• Drink plenty of water.
• Don’t smoke.
• Steer clear of caffeine.
• Stick to a healthy diet that’s low in fat and protein.
• Eat smaller and more frequent meals.

Call your healthcare provider when you start to have short-term (acute) symptoms, including:

• Severe pain that can’t be eased at home
• Vomiting and are unable to keep down fluids

Key points about chronic pancreatitis

• Acute pancreatitis is a sudden inflammation of your pancreas. If your acute pancreatitis doesn’t get better and slowly gets worse, you have chronic pancreatitis.
• If you have chronic pancreatitis, the digestive enzymes that would normally travel by tubes inside your pancreas and empty into your upper intestine, become trapped inside your pancreas.
• Your healthcare provider will examine your belly. You will be asked about your drinking history and any family history of pancreatic disease or cystic fibrosis.

• Day-to-day treatment includes pain medicine, pancreatic enzyme supplements with every meal, insulin if you develop diabetes, and vitamin supplements if needed.

• If you have been diagnosed with chronic pancreatitis, your healthcare provider may suggest lifestyle changes.

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your healthcare provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your healthcare provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your healthcare provider if you have questions.

Medical Reviewer: Jen Lehrer MD

Medical Reviewer: Rita Sather RN

Medical Reviewer: Raymond Kent Turley BSN MSN RN

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.