The pancreas is a vital organ that helps with digestion and blood sugar regulation with the hormone insulin. This occurs when the pancreas becomes inflamed due to activation of digestive enzymes in the pancreas before they are supposed to be released into the small intestine. It can either be acute or chronic, both of which require medical attention and follow-up.
Acute pancreatitis can range in severity from mild to serious and usually lasts for several days. Regardless of severity, it is recommended that you receive immediate medical attention if the symptoms below occur, as it can be fatal. Gallstones that block the bile duct and impede with the functioning of the pancreas are the most common cause to this condition. Other causes include high triglyceride levels, medication, high calcium levels, and heavy alcohol use. This condition is typically diagnosed with a blood test, ultrasound of the abdomen, endoscopic ultrasound, and/or imaging tests (such as a CT or MRI). This type is temporary in nature and does not typically last for more than several weeks.
1. Upper Abdominal Pain
Upper abdominal pain is the most prominent symptom of acute pancreatitis. Patients most commonly report pain on the upper left side and/or middle of the abdomen, which is typically the area below the breastbone or sternum.
The course of abdominal pain can vary based on the cause and the individual patient. Pancreatic inflammation due to gallstones usually consists of pain that develops more suddenly, whereas inflammation due to heavy alcohol use develops more slowly over several days. Pain can occur within minutes after eating or drinking, particularly if the items have high contents of fat. Abdominal pain can also occur within 12 to 24 hours after a large meal or period of heavy drinking. Pain typically becomes more constant and increases in severity over time as it progresses. However, abdominal pain can also subside in some cases as the condition advances because the pancreas is no longer making digestive enzymes.
Although pain is often localized to the upper abdomen, some patients experience pain that radiates down the back as well. Certain individuals experience increased severity of pain when lying on their back. The stomach may also become distended (or swollen) and patients with this condition can experience tenderness in their abdomen.
2. Nausea
Nausea is frequently associated with abdominal pain due to pancreatic inflammation. Unlike vomiting, this is a discomfort in the abdomen that often accompanies the act of purging but does not necessarily produce vomit. It is common in a variety of conditions such as food poisoning, pregnancy, and the flu. However, it can also be a symptom of a more serious condition such as pancreatic inflammation. Given that this condition has a negative impact on the digestive system, patients often experience nausea and general feelings of illness. Nausea due to pancreatic inflammation can be disabling for patients and lead to a loss of appetite.
3. Vomiting
Although some patients with acute pancreatic inflammation only experience nausea, vomiting is common as well. Dysfunction of the pancreas, such as pancreatitis, causes this when excess fluids and air accumulate in the stomach. As a result, the body’s natural defense is to rid itself of the excess fluid and air, leading to persistent vomiting. This can frequently be uncontrollable during an episode of acute pancreatitis and can cause the individual to dry heave (in other words, the act of purging without producing vomit). Unlike the common flu, this often does not provide relief of symptoms for patients with this condition.
4. Back Pain
In addition to discomfort associated with the stomach, back pain can also occur. Pain is most commonly reported behind the ribs (otherwise known as the thoracic spine) in acute pancreatitis. Back pain from pancreatic inflammation often radiates to the left shoulder in the middle or below the shoulder blade. Back pain is thought to be the result of the anatomical position of the pancreas along the backside of the abdominal wall. It is also thought to be the result of nerves that connect the pancreas to the spinal cord nerves of the thoracic spine. Patients who experience back pain might seek treatment for this first if other symptoms are comparatively mild or in the early stages.
5. Bloating
In acute pancreatitis, the stomach may become distended (or swollen) due to the inflammation of the pancreas and dysfunction of pancreatic enzymes. Bloating and gas is common in chronic pancreatitis and can be an everyday experience for individuals with this condition. This is a result of digestion issues in the small intestine. Pancreatic enzyme dysfunction prevents food from being broken down properly in the small and large intestines, which causes the bacteria within these organs to produce intestinal gas. The gas then permeates through the wall of the gut and causes bloating. In addition to bloating and gas, individuals with chronic pancreatic inflammation often experience abdominal pain and flatulence associated with excess gas.
6. Fat in Stool
Fatty stools, otherwise known as steatorrhea, occur when the digestive system does not properly absorb the nutrients in food. This happens when the pancreas is inflamed because of dysfunction of the pancreatic enzymes that do not appropriately break down food material for digestion. As a result, stools are left with excess fat and are bulky, pale, and oily in appearance. Fatty stools are also foul in terms of smell relative to normal stools. The presence of fatty stools is most common in chronic pancreatitis, but there are other conditions that also can cause fatty stools. These include other disorders of pancreatic dysfunction (cystic fibrosis, pancreatic cancer), conditions that affect bile salts (bile duct obstruction due to gallstones), celiac disease, or irritable bowel syndrome.
7. Indigestion
Indigestion can consist of heartburn, feeling full or bloated, excess gas, or bringing up bitter-tasting fluids or undigested food. This is common in individuals with pancreatic inflammation as a result of dysfunction of pancreatic enzymes that help to break down food into nutrients. As previously mentioned, pancreatic dysfunction can lead to several gastrointestinal problems such as gas and fatty stools. According to one study done by Mokrowiecka, Pinkowski, Malecka-Panas, & Johnson (2010), indigestion is one of the most significant factors that impacts quality of life in patients with chronic pancreatitis. Individuals who reported more severe symptoms of indigestion endorsed lower quality of life compared to those with less severe symptoms.
8. Loss of Appetite
As is often accompanied with indigestion and other stomach-associated discomforts, patients with pancreatitis can also experience a loss of appetite. A decrease in appetite can occur in many diseases or disorders such as depression, drug use, thyroid dysfunction, dementia, or heart failure. With pancreatic inflammation, loss of appetite can be due to several issues such as increased abdominal pain that occurs immediately after eating or abdominal discomfort due to bloating or excess gas. For individuals with any chronic disease such as chronic pancreatitis, an adjustment period associated with anxiety and/or depression is to be expected and may affect appetite as well.
9. Sweating
Along with abdominal symptoms and pain, sweating can also be a symptom of acute and/or chronic pancreatitis. Fever is a common symptom of acute pancreatitis, which frequently leads to perspiration. Excessive sweating can also occur with fluctuations in blood sugar levels, which are controlled by the pancreas, and is often associated with diabetes (another disease of the pancreas).
Though all of us sweat as a way to regulate body temperature, individuals with pancreatic dysfunction can experience hyperhidrosis, or excessive sweating that is unrelated to temperature regulation. This occurs when glucose levels are too low (hypoglycemia), which causes the body to respond with excess production of adrenaline and norepinephrine. These hormones are associated with the flight or fight response and cause excess sweating. Night sweats due to hypoglycemia can also occur in individuals with pancreatic dysfunction.
10. Fast Heart Rate
Another systemic symptom of pancreatic inflammation is increased heart rate, and is especially the case with acute pancreatitis. Vital signs, such as heart rate, are often negatively impacted by an episode of acute pancreatitis. Heart rate during one of these episodes can range from 100 to 140 beats per minute. This is fairly high given that a normal heart rate for adults at rest is 60 to 100 beats per minute. Other vital signs associated with rapid heart rate include shallow and rapid breathing and fluctuations in blood pressure from low to high with postural hypotension (low blood pressure upon standing up).
11. Weight Loss
As previously mentioned, pancreatitis can cause dysfunction in absorption of nutrients in the digestion system, vomiting, and loss of appetite. All of these problems individually or in combination can lead to weight loss. Malabsorption is one of the most prominent reasons for weight loss in pancreatitis and can contribute to weight loss despite normal eating habits and appetite. Given that one cause of pancreatic inflammation is a diet with high fat content, individuals with pancreatitis are often encouraged to eat a low-fat diet. Therefore, individuals might not as easily be able to gain weight when attempting to control their pancreatitis with their diet.
