Treating acute pancreatitis

If you develop acute pancreatitis, hospital care will focus on supporting your body until the pancreas can recover. This involves giving you fluids through a vein, and providing pain relief and antibiotics if you have an infection. You cannot eat and often a nasogastric tube is put in place. This removes excess fluid from the stomach to prevent constant vomiting and may provide liquid nutrition until you can eat again.

Severe acute pancreatitis is usually treated in an intensive care unit so that complications such as kidney failure can be monitored and treated promptly.

Preventing further episodes of acute pancreatitis will depend on the cause but alcohol should be avoided for several months in any case. If tests show you have gallstones, you will need them removed.

Treating chronic pancreatitis

Therapy for chronic pancreatitis is about prevention as well as treatment of symptoms:

  • You will need to avoid alcohol and tobacco completely.
  • You will need pain relief: this may involve input from a pain clinic as it can be a difficult problem to manage.
  • If your pancreas cannot produce enough digestive enzymes, you will need to take synthetic enzymes with your meals.
  • If you develop type 2 diabetes, you will need diabetes care, probably with insulin injections.
  • You may be advised to reduce the amount of fat you eat.
  • Endoscopic treatment using ERCP can widen a narrowing or stricture in the pancreatic duct, and then keep it open by stenting. This can remove the pain of chronic pancreatitis quite successfully in some patients.
  • Surgery to remove the pancreas can also be done in patients whose pancreatitis recurs despite repeated endoscopic treatments.

New techniques are being developed to transplant pancreatic islet cells into the liver during the operation. These ‘take’ and produce pancreatic hormones, reducing the incidence of type 2 diabetes post-surgery.