Pancreatitis

Treatment

Acute Pancreatitis

Mild cases of acute pancreatitis generally improve in a week or less. Moderate to severe cases take longer to improve. Severe acute pancreatitis usually requires a longer hospital stay; patients with complications may be admitted to the intensive care unit.

General Treatment

Treatment goals include controlling pain, allowing the pancreas to rest and restoring a normal balance of fluid and electrolytes. Because the pancreas is active when eating, patients generally receive fluids intravenously until inflammation subsides.

Treatment for Addictions

If alcohol use is the cause of pancreatitis, treatment for alcohol abuse/chemical dependency is recommended.

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Gallstones

When gallstones pass into the common bile duct, acute pancreatitis can occur. Physicians may recommend a procedure — endoscopic retrograde cholangiopancreatography (ERCP) — to remove the stones remaining in the bile duct. Read more about the ERCP procedure on a National Institutes of Health Web site.

Eventually, to prevent future attacks of gallstone pancreatitis, removing the gallbladder in surgery is recommended.

When surgery is necessary to treat complications of acute pancreatitis, Mayo medical professionals use advanced imaging technology to determine the best treatment options for patients.

Chronic Pancreatitis

The main goals of treatment for chronic pancreatitis are to stop alcohol consumption, control pain and improve malabsorption problems.

Chemical Dependency Treatment

This is probably the most important step in treating alcohol-related pancreatitis. In the disease's early stages, abstinence from alcohol may relieve even severe pain. As pancreatitis progresses, continued alcohol use greatly increases the risk of complications and death; patients who continue drinking have a death rate three times higher than those who abstain.

Pain Relief

Unlike acute pancreatitis, where pain often disappears within a few days to weeks, chronic pancreatitis pain can linger. This is challenging, because conventional pain relievers are often ineffective and pose a risk of addiction. A multidisciplinary team of gastroenterologists, radiologists, surgeons, endoscopic therapists and pain medicine specialists use behavioral modification and medications to limit narcotic use.

Enzyme Therapy for Malabsorption

Enzyme supplements such as pancrelipase can help treat problems with maldigestion. By replacing missing enzymes, these tablets help restore normal digestion and alleviate steatorrhea, leading to weight gain and enhanced well-being. Depending on the enzyme preparation used, patients may take up to eight tablets with meals — two tablets after eating a few bites, four during the meal and two after the meal or with snacks.

Dietary Changes

Doctors may recommend eating smaller meals and limiting fats, to help reduce the need for digestive enzymes.

Treatment for Diabetes

Chronic pancreatitis can sometimes trigger diabetes. If so, treatment usually involves maintaining a healthy diet and exercise regularly. Some patients also need insulin injections, although insulin must be used cautiously to avoid low blood sugar (hypoglycemia). Doctors inform patients how to manage diabetes, recognize symptoms of high and low blood sugar and prevent complications.