Acute pancreatitis


How is acute pancreatitis treated?
Acute pancreatitis is classified into mild pancreatitis and severe pancreatitis depending on the severity of the condition. Mild cases often recover within a week without residual effects; severe cases are perilous with a poor prognosis, and the mortality rate ranges from 20% to 40%. Treatment for mild pancreatitis includes fasting, gastrointestinal decompression, pain relief, antibiotics, intravenous nutrition, acid suppression, enzyme inhibition, etc. In addition to the aforementioned treatments, severe pancreatitis requires strict medical monitoring to maintain electrolyte balance, early parenteral nutrition transitioning to enteral nutrition, and the use of antibiotics to reduce pancreatic fluid secretion, such as the growth inhibitor octreotide, as well as enzyme activity suppressants like gabexate. If the pancreatitis is biliary in origin, an ERCP with a sphincterotomy of the sphincter of Oddi may be performed. In case of serious complications, surgical treatment may be considered. (Medications should be used under the guidance of a doctor.)


Is the recurrence rate of acute pancreatitis high?
After recovering from acute pancreatitis, if patients do not pay careful attention to their diet, there is a significant risk of relapse. For example, they should not drink alcohol excessively, overeat, or consume greasy foods. Also, if the acute pancreatitis is caused by conditions such as gallstones, it is important to have the gallbladder removed promptly. Without gallbladder removal, the recurrence rate of the disease noticeably increases. Patients with acute pancreatitis should initially eat foods that are easy to digest and low in protein and fat, such as carbohydrates that are also easy to swallow. Once the patient's condition significantly improves, they can gradually transition to a diet higher in protein and vitamins, among other nutrients.


Is acute severe pancreatitis serious?
Acute severe pancreatitis is a very serious disease in clinical practice, with a high mortality rate, often requiring comprehensive treatment in the ICU. Acute severe pancreatitis is a disease caused by multiple etiologies that results in localized inflammation, necrosis, and infection of the pancreas, accompanied by a systemic inflammatory response and persistent organ failure. It is divided into three phases. The first phase is the acute response phase, occurring from onset to about two weeks, characterized by systemic inflammatory response; the second phase is the systemic infection phase, occurring from two weeks to about two months, characterized by necrosis and infection of the pancreas or peripancreatic tissues; the third phase is the residual infection phase, occurring two to three months later, with clinical manifestations primarily of systemic malnutrition and persistent fistulas, accompanied by gastrointestinal fistulas.


Which department should I go to for acute pancreatitis?
If acute pancreatitis occurs, it is recommended to register with the Department of Gastroenterology. Acute pancreatitis is generally divided into acute edematous pancreatitis and acute necrotizing pancreatitis. The common form of pancreatitis in daily life is acute edematous pancreatitis, which can be treated conservatively with medication in the gastroenterology department. If acute necrotizing pancreatitis occurs, surgery may be required. In such cases, after registering with the gastroenterology department and identifying a severe condition, an appropriate transfer to another department for treatment can be made. After all, when initially arriving at the hospital, without a detailed examination, it is unclear whether it is edematous or necrotic pancreatitis.


Can I eat lamb with acute pancreatitis?
Patients with acute pancreatitis must not eat or drink during the acute phase. Absolutely no binge eating or drinking should occur, as it can lead to gastrointestinal dysfunction, obstruct the normal movement and emptying of the intestines, and hinder the normal drainage of bile and pancreatic juice, thereby easily triggering an attack of acute pancreatitis. Alcohol must also be avoided, as excessive drinking can lead to chronic alcohol poisoning and malnutrition-related liver and pancreatic damage, reducing the patient's ability to fight infections and also easily triggering and exacerbating acute pancreatitis.


Can acute pancreatitis patients have sexual intercourse?
Patients with acute pancreatitis cannot have sexual intercourse during the acute treatment period because it can lead to physical exhaustion and further weaken the patient's condition. Therefore, during the acute phase of acute pancreatitis, the focus should be on rest, and the diet should include foods rich in vitamins and carbohydrates, such as starchy foods, fresh vegetables, and fruits. It is important to avoid overeating, greasy foods, and alcohol consumption. If patients with acute pancreatitis recover fully, and their physical strength is completely restored, they may then consider resuming sexual activity.


Can you drink water with acute pancreatitis?
Patients with acute pancreatitis cannot drink water or eat anything during the acute phase. They must undergo gastrointestinal decompression to suction out gastric juice, gastric acid, and gastric contents. At the same time, treatment for acute pancreatitis includes inhibiting pancreatic secretion, anti-infection measures, intravenous fluid replenishment, and maintaining electrolyte balance, among others. If a patient with acute pancreatitis experiences bowel movements, gas, relief from abdominal pain, and a decrease in blood amylase to normal levels, they may then consider drinking small amounts of water and consuming light foods like rice soup or thin porridge. If the abdominal pain disappears, the patient can gradually increase their water intake.


What is acute pancreatitis and is it serious?
Acute pancreatitis is relatively common in clinical practice, which generally refers to inflammatory changes in the pancreas caused by various reasons, such as exudation and necrosis of the pancreas. Depending on the condition, it is divided into mild and severe pancreatitis. Generally, mild pancreatitis has a good prognosis with a treatment period of about one to two weeks through conservative medical treatment, and it typically heals on its own. However, severe pancreatitis with accompanying organ failure, such as liver, kidney, or respiratory failure, or the presence of local complications like abscesses, fever, pseudocysts, obstruction, etc., generally has a longer treatment period, poorer prognosis, and higher treatment costs. Therefore, the treatment outcomes vary depending on the severity and urgency of the acute pancreatitis. It is recommended that patients considering acute pancreatitis should continue diagnosis and treatment at a local hospital. Particular attention must be given to severe pancreatitis.


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.


What IV fluids should be administered for acute pancreatitis?
If the diagnosis confirms acute pancreatitis, venous medication generally involves the use of proton pump inhibitors to suppress gastric acid, which also helps reduce the secretion of pancreatic enzymes. Meanwhile, to prevent infection, antibiotics can be used appropriately. Medications that reduce pancreatic secretion, such as octreotide or somatostatin, can be considered, as well as drugs that inhibit pancreatic enzyme activity. Since patients with pancreatitis must abstain from food and water intake, it is important to pay attention to energy intake and maintain electrolyte balance. Once acute pancreatitis is confirmed, it is essential to seek hospital treatment as this condition can be quite dangerous. All mentioned medications should be used under the guidance of a doctor.