What is acute pancreatitis and is it serious?

Written by Zhu Dan Hua
Gastroenterology
Updated on September 11, 2024
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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.

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Does acute pancreatitis affect the rise in blood sugar?

After the onset of acute pancreatitis, pathological changes occur in the pancreas, affecting both its endocrine and exocrine functions. The endocrine function includes the secretion of insulin, which can lead to insulin resistance, impacting glucose metabolism and causing an increase in blood sugar levels. Therefore, after admission, it is routine to monitor the blood sugar levels of patients with acute pancreatitis and manage insulin resistance. Additionally, due to the increased blood sugar levels, there is a higher risk of infection in these patients. Depending on the cause of the condition, targeted treatment is necessary along with the early use of antibiotics to control the progression of pancreatitis, reduce the rate of infections, and promote recovery of the body.

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What are the causes of acute pancreatitis?

There are many causes of acute pancreatitis. Common primary causes include improper diet: overeating, alcohol consumption, preference for spicy or rich foods, etc. Additionally, hyperlipidemia and cholelithiasis are also reasons, along with surgical trauma such as cholangiography, gastrectomy, etc. Other diseases can also lead to acute pancreatitis, such as hypercalcemia, diabetic coma, hyperparathyroidism, rheumatism, necrotizing vasculitis, etc.; viral infections can also cause pancreatitis, and long-term use of medications can cause acute inflammation, such as tetracycline, corticosteroids, etc. Acute pancreatitis initially presents with severe, acute abdominal pain, commonly in the left, upper middle quadrant, and occasionally radiating to the back. Subsequently, vomiting, fever, and in severe cases, shock may occur. Acute pancreatitis is a type of acute abdomen and can be life-threatening. If symptoms occur, it is crucial to seek immediate hospital treatment.

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Causes of vomiting in acute pancreatitis

Acute pancreatitis vomiting has various causes. Firstly, the pancreas is a digestive organ, and upon the onset of pancreatitis, a large amount of pancreatic enzymes is secreted, which significantly affects digestive functions. This easily causes gastrointestinal reactions, and if undigested stomach contents remain in the stomach cavity for too long, it will increase stomach cavity pressure, leading to frequent vomiting. The vomiting caused by acute pancreatitis generally does not alleviate symptoms after vomiting. The treatment primarily targets acute pancreatitis, including enzyme inhibition, acid suppression, and fasting to help reduce vomiting. The occurrence of vomiting is also related to increased intra-abdominal pressure. Following the onset of acute pancreatitis, if treatment is not timely, it can lead to increased intra-abdominal pressure. This increase in pressure can affect gastrointestinal motility, causing reflexive symptoms of nausea and vomiting.

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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.

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Differences between acute pancreatitis and acute gastritis

Acute pancreatitis and acute gastritis have somewhat similar symptoms, but there are fundamental differences between them. The onset of pancreatitis is often considered to be caused by biliary, alcoholic sources, or hyperlipidemia, while acute gastritis is mostly related to the stomach being affected by the cold and gastric erosion causing gastritis. During a symptom attack, a comprehensive diagnosis should be made by combining the patient's previous medical history and the characteristics of the symptom onset, as well as laboratory tests and imaging findings. The treatment of acute pancreatitis and acute gastritis also shows distinct differences: acute pancreatitis requires fasting, abstention from drinking, acid suppression, use of magnesium, and correction of fluid and electrolyte balances, along with regular check-ups to prevent the development of pancreatitis. On the other hand, treatment for acute gastritis involves acid suppression and, when necessary, gastric protection.