Abdominal Pain May Be a Sign of Pancreatitis

16. September 2015

Summer is BBQ season as well as the ideal time for other events where lots of food and drinks are served. Also, when on vacation, people are more prone to over-indulging in special treats. According to Dr. Airi Oeselg, that is the reason why every day a couple of pancreatitis patients end up in the emergency room.

Airi Oeselg, surgeon at East Tallinn Central Hospital, says that in the summer season, every day one or two patients seen in the emergency room are diagnosed with pancreatitis. As a rule, these are not acute cases, but still, for the patient, this means painkillers, a special diet and often a ruined vacation.

“In 70% of the cases, the disease is caused by excess alcohol consumption, in 20% of the cases by gallstones and in the rest of the cases, the pancreas has been irritated whether by foods high in fat or by an injury to the abdominal region,” explains Dr. Oeselg. Sometimes, it is tumours or medication that triggered abdominal pain that makes people seek help from the emergency department.

Average patient: male who has recently reached middle age

Although everyone is at risk of developing pancreatitis, according to Dr. Oeselg it is mostly males in their late 30s who come in with alcohol-related pancreatitis. Why doesn’t the same amount of alcohol trigger a disease in one patient, but not in another? Presumably because people’s bodies contain varying amounts of the enzyme that is needed to break down alcohol. Also, genetics is thought to play a role.

“As a rule, patients who come in suffer from a sudden onset of abdominal pain just below the ribs and the pain may radiate laterally to the sides and back,” explains Dr. Oeselg, adding that usually eating only intensifies the pain.

If inflammation is caused by gallstones, the pain worsens in a few hours, but if inflammation is induced by alcohol consumption, the pain reaches its maximum severity only after a couple of days. Lying crunched up, or in foetal position, may somewhat relieve the pain. Other indistinct symptoms, such as vomiting, nausea, diarrhoea, loss of appetite, fever, upper abdominal pain or yellow discoloration of skin after heavy drinking or after eating a hearty, fatty meal, may also be a sign of pancreatitis.

A blood test is enough to make a diagnosis

The doctor adds that all kinds of severe abdominal pain that do not decrease in half an hour require medical attention. “While the majority of those coming in are diagnosed with non-acute pancreatitis, every fifth patient seeking medical care due to pancreatitis has a fast-progressing form of the disease,” says the doctor, warning everyone that a sudden onset of abdominal pain is not a matter to be taken lightly as it may turn out to be fatal.

The surgeon says that a simple blood test is enough to establish whether a person is suffering from pancreatitis or not. “All patients who are admitted with a suspicion of pancreatitis must undergo an abdominal ultrasound – this is to diagnose inflammation caused by gallstones, because the latter requires treatment that is very different from the one given in cases of alcohol-induced inflammation. Patients suffering from a fall or abdominal trauma must also undergo a CT scan,” explains Dr. Oeselg.

Although mild pancreatitis clears in three to five days and does not require specialised treatment, patients with severe abdominal pain should still seek medical help. In addition to receiving help to relieve their symptoms, this helps to prevent future problems with pancreatic function.

“But acute pancreatitis requires prolonged hospitalisation and partial pancreatic necrosis may occur. This, in turn, creates favourable conditions for bacteria and sepsis. Patients in a severe condition who are unable to drink and eat independently are fitted with a gastric feeding tube. It may be the case that a patient requires a breathing machine and once in a while dead pancreatic tissue has to be removed surgically,” explains Dr. Oeselg.

If pancreatitis is caused by gallstones blocking the bile duct, the patient first has to undergo endoscopy to clear the duct and then the gallbladder is removed. In more severe cases, the patient is sent home for at least six weeks to recover and then hospitalised again to perform elective gallbladder surgery.

How can you keep your pancreas healthy?

According to the surgeon, high-fat foods should be avoided when suffering from the irritation or inflammation of the pancreas.

“Because the pancreas is not able to properly secrete the enzyme needed for breaking down fat, the condition may worsen. So, it is advisable to eat yoghurt and vegetable soups. However, it does not mean that meat should be cut out entirely – simply switch to lean meat, such as chicken. Blueberries and grapefruit are an excellent choice,” because according to Dr. Oeselg, they support recovery of the pancreas due to their high antioxidant content.

When there is inflammation in the body, drink lots of liquids, excluding soft drinks and other carbonised beverages. Instead, prefer weak teas and water.

“Those who have suffered once from pancreatitis must reduce their alcohol consumption and those who have had alcohol-induced pancreatitis must abstain from alcoholic drinks for the rest of their life,” says Airi Oeselg, surgeon at East Tallinn Central Hospital, being strict about the matter.

Also, patients with a history of pancreatitis must steer clear of wheat flour-based products, including pasta, as well as red wine, meat and coffee. They would do well to avoid processed foods and baked goods, frozen pizza, cheese, beans, eggs and butter.

Smoking is prohibited for at least a month after suffering pancreatitis, because it inhibits the recovery of the pancreas.

Pancreatitis management

Tips for fast recovery

  • Drink lots of liquids, excluding soft drinks.
  • Eat smaller portions.
  • Prefer foods that are easy to digest.
  • Abstain from alcohol.
  • Get enough sleep.
  • Avoid physical exertion.


Source: Õhtuleht