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JAMA Patient Page
April 11, 2012

Pancreatitis

JAMA. 2012;307(14):1542. doi:10.1001/jama.2012.386

The pancreas, an organ located behind the stomach in the upper abdomen, produces enzymes and hormones. The enzymes are discharged through the pancreatic duct into the intestine, where they help digest food that has passed through the stomach. The hormones produced by the pancreas, including insulin and glucagon, are released into the blood and help regulate blood sugar levels. Pancreatitis is an inflammation of the pancreas. Pancreatitis is a severe illness with several forms. The March 14, 2012, issue of JAMA included an article about treatment of severe pancreatitis. This Patient Page is adapted from one published in the April 2, 2008, issue of JAMA.

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RISK FACTORS FOR PANCREATITIS

  • Alcohol abuse

  • Gallstones

  • Abdominal trauma

  • Major surgery

  • Inherited diseases affecting the pancreas, including cystic fibrosis

  • High blood levels of calcium (usually due to other medical problems)

  • High blood levels of triglycerides (a particular type of fat in the blood)

ACUTE PANCREATITIS

Acute pancreatitis typically causes severe pain in the abdomen and middle of the back, often associated with nausea and vomiting. Because pancreatitis can be severe and life-threatening, hospital care may be required. In severe cases of acute pancreatitis, shock may occur, requiring intensive care and supportive therapy.

GALLSTONE PANCREATITIS

Gallstone pancreatitis is caused by irritation of the pancreas by gallstones in the pancreatic duct. Jaundice (yellowing of the skin) may occur with this type of pancreatitis. Cholecystectomy (surgical removal of the gallbladder) is necessary to prevent gallstone pancreatitis from occurring again. Because acute gallstone pancreatitis may be a severe illness, several days of supportive care (which may include antibiotics and intravenous fluids in the hospital) may be required before a person is ready to have the gallbladder removed.

CHRONIC PANCREATITIS

Chronic pancreatitis is inflammation and scarring of the pancreas that occurs over a long period. Heavy alcohol use is a common cause. Persons with chronic pancreatitis may have abdominal pain that is either constant or episodic (comes and goes). Scarring of the pancreas may lead to failure to produce enough enzymes to digest food and a lack of insulin, leading to diabetes. Persons who have acute or chronic pancreatitis may develop a complication called a pseudocyst. This is a fluid collection in or around the pancreas. It may push on or cause pressure on other abdominal organs, creating other symptoms. These pseudocysts can also become infected, causing serious illness.

FOR MORE INFORMATION

INFORM YOURSELF

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's website at www.jama.com. Many are available in English and Spanish.

Sources: American Gastroenterological Association, National Institute of Diabetes and Digestive and Kidney Diseases, National Pancreas Foundation

Topic: GASTROINTESTINAL HEALTH

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

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