Acute pancreatitis is a sudden inflammation of the pancreas — an organ behind the stomach that helps in digesting food and controlling blood sugar. When the pancreas becomes inflamed, its digestive enzymes start attacking its own tissue, causing severe pain and illness. This condition can range from mild to life-threatening, so recognising it early and seeking medical care immediately is very important.
If you are experiencing sudden severe upper abdominal pain, Hope Plus can help you talk to a licensed healthcare provider within minutes for quick guidance and referral to a nearby facility if needed. You can access it here: https://hope.co.ug/plus/.
Key Takeaways
- Acute pancreatitis is a medical emergency that requires hospital care.
- It is often caused by excessive alcohol intake or gallstones.
- The main symptom is severe upper abdominal pain that moves to the back.
- Treatment focuses on rest for the pancreas, IV fluids, pain control, and nutrition.
- Avoiding alcohol and certain drugs can help prevent future episodes.
Causes of Acute Pancreatitis
Several factors can trigger inflammation of the pancreas:
- Excessive alcohol intake
- Gallstones or diseases of the bile duct
- Infections such as mumps, HIV, hepatitis A, or worms like ascaris
- Certain medicines such as sulphonamides, furosemide, lamivudine, or some painkillers
- Peptic or duodenal ulcers
- Poisoning, for example from organophosphates (found in some pesticides)
Symptoms of Acute Pancreatitis
The main symptom is sudden severe abdominal pain, often felt in the upper middle area (just below the ribs) and spreading to the back. Other symptoms include:
- Pain that worsens when eating or lying down, but eases when sitting up or leaning forward
- Nausea and vomiting
- Swollen or bloated abdomen
- Fever and rapid heartbeat
- Dehydration, which can be severe and lead to shock in serious cases
The abdomen is usually very tender when touched, but may not feel hard unless there is infection in the abdominal lining.
Possible Complications
If not treated promptly, acute pancreatitis can lead to:
- Pancreatic pseudocysts (fluid-filled sacs)
- Infected or dead pancreatic tissue (necrosis)
- Peritonitis (infection of the abdominal cavity)
- Diabetes mellitus due to damage to the pancreas
How Acute Pancreatitis Is Diagnosed
Healthcare providers diagnose pancreatitis through:
- Blood tests for pancreatic enzymes (amylase and lipase), which are usually three times higher than normal
- Ultrasound scans to detect gallstones, fluid around the pancreas, or swelling
- Liver function tests to check for blocked bile ducts
- Blood sugar levels, as high sugar is common during an attack
Treatment and Management
Acute pancreatitis is treated in hospital. The goals are to rest the pancreas, control pain, prevent dehydration, and address the underlying cause.
1. Fluid Replacement and Monitoring
- Early and aggressive IV fluid therapy is given to prevent dehydration and maintain blood flow.
- Ringer’s Lactate or other isotonic fluids are used, adjusted according to body weight and urine output.
- Electrolyte levels and vital signs are closely monitored.
2. Pain Control
Strong painkillers are used to manage severe pain, such as:
- Paracetamol (IV or rectal) every 6–8 hours
- Pethidine or morphine injections for stronger pain relief
- Doctors monitor for side effects like constipation or drowsiness.
- Non-steroidal anti-inflammatory drugs (NSAIDs) are usually avoided.
3. Controlling Nausea and Vomiting
- Metoclopramide injections are used to control vomiting.
- A nasogastric tube may be inserted to remove stomach fluids if vomiting is severe.
4. Feeding and Nutrition
- Eating or drinking is stopped until pain and inflammation reduce.
- During this period, IV glucose (dextrose) is given to provide energy.
- Once the patient feels hungry and can tolerate food (usually within 2–3 days), feeding is restarted gradually:
- Begin with clear liquids (like water or light soups)
- Move to soft, low-fat foods
- Then return to a normal diet as tolerated
- If eating is not possible, doctors may use parenteral nutrition (nutrition through the veins).
5. Managing Blood Sugar
High blood sugar is common during pancreatitis, so blood glucose is regularly checked and kept between 6–9 mmol/L.
6. Antibiotic Use
Antibiotics are not routinely given unless there is a confirmed infection, such as a urinary tract infection, lung infection, or infected pancreatic tissue.
7. Treating the Underlying Cause
- Stop alcohol use immediately.
- Treat gallstones or bile duct problems if found.
- Avoid drugs that can harm the pancreas.
8. Severe Cases (Moderate or Severe Pancreatitis)
If the condition causes organ failure or other complications, patients are referred to a higher-level facility (HDU/ICU) for specialised care. This may include:
- Oxygen or mechanical ventilation
- Kidney support (dialysis if needed)
- Management of fluid collections or infected pancreatic tissue
Prevention
- Reduce or avoid alcohol consumption.
- Avoid unnecessary use of harmful drugs known to affect the pancreas.
- Maintain a healthy, balanced diet and drink plenty of water.
- Seek medical advice early if you experience severe upper abdominal pain.
FAQ: Common Questions About Acute Pancreatitis
1. What is the main cause of acute pancreatitis in Uganda?
The most common causes are heavy alcohol use and gallstones.
2. Can acute pancreatitis go away on its own?
Mild cases can improve with hospital treatment and rest for the pancreas, but medical supervision is always needed.
3. Can I eat during treatment?
No, eating is stopped until inflammation reduces. Doctors will restart feeding gradually when it is safe.
4. How long does recovery take?
Mild cases usually improve in a few days. Severe cases may take weeks and need hospital monitoring.
5. Can pancreatitis come back?
Yes, especially if alcohol use continues or gallstones are not treated. Avoiding these triggers helps prevent recurrence.
6. What foods should I eat after recovery?
Choose light, low-fat meals, plenty of fruits, vegetables, and water. Avoid greasy, fried, or spicy foods.
7. Can pancreatitis cause diabetes?
Yes, repeated or severe attacks can damage the pancreas, reducing its ability to control blood sugar.
