Pancreatitis

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Treatment

The goals of treatment for pancreatitis are to reduce inflammation, relieve pain, and reduce the risk for complications and further attacks. Patients who have a history of pancreatitis should avoid alcohol and large meals, and should eat a healthy diet that is high in carbohydrates and protein and low in fat.

Damage to the pancreas (e.g., in chronic cases) may prevent secretion of digestive enzymes and lead to malabsorption. Patients who experience malabsorption may be instructed to take pancreatic enzyme supplements with each meal. This treatment is called pancreatic enzyme replacement therapy.

Pancreatic enzyme supplements (e.g., proteolytic enzymes, lipase, amylase) are enteric-coated, which means that the enzymes are protected by a special coating so that they do not start working before they reach the small intestine. These supplements are available by prescription.

Acute pancreatitis usually resolves on its own in about 3 to 7 days, as long as complications do not develop. During an acute attack, the patient is closely monitored; analgesics are used to reduce pain; fluids are administered through an IV (i.e., intravenously); and eating and drinking are restricted to limit activity of the pancreas. In severe cases, total parenteral nutrition (intravenous feeding) may be necessary.

Patients who develop complications may require additional treatment, including the following:

• Antibiotics (to treat infection; also may be administered to prevent infection [called prophylactic antibiotics])
• Dialysis (to treat kidney failure)
• Insulin (to treat diabetes)
• Oxygen therapy or a ventilator (to treat lung failure)
• Stomach tube (to treat severe vomiting)
• Surgery (e.g., to remove gallstones, other obstructions [pseudocysts], scarring, or severely damaged tissue; to stop bleeding; or to drain an infection)

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