Difference Between Acute vs Chronic Pancreatitis

 

While not exactly the biggest priority in people’s minds the pancreas is an important gland that produces several hormones, including insulin, glucagon, and somatostatin, as well as secretes pancreatic juice that contains digestive enzymes and then passes to the small intestine. The enzymes created and transferred to the small intestine help your body break down fats, proteins, and carbohydrates. Although not the star of the show the pancreas remains a fundamentally crucial part of the human body because it generates so many nutrients for us. This vital organ unfortunately is susceptible to illness and disease as the enzymes that travel from the pancreas to the small intestine can instead build up and become active in the pancreas. This is commonly known as pancreatitis and although the name and even the symptoms may seem familiar to many, the difference from acute and chronic can be life-saving knowledge.

 

The Misconception about Pancreatitis

The causes for pancreatitis can be many and often not what people think of when the topic comes to mind. There are misconceptions that mainly revolve around alcohol consumption as the one and only cause for pancreatitis. While it is common to develop the disease due to excessive drinking in both acute and chronic cases, other causes can rise and start the inflammation of pancreatitis. RMPancreatitis points to cancer, types of medications, infections, genetics, gallstones, even the result of a car accident that injures the abdominal section as other causes for pancreatitis. It’s good to stay aware of these factors and not categorize pancreatitis under one condition, but instead multiple causes that at times cannot be avoided just by healthy living.

 

The Similarity and Difference in Symptoms

The symptoms for acute and chronic pancreatitis can be very similar and difficult to tell apart initially. The National Center for Biotechnology Information (NCBI) breaks down the symptoms.
For acute pancreatitis some symptoms may include:

  • A sudden attack of pain in the upper abdominal area that can last for hours or days.
  • Pain radiating from the abdomen to the back.
  • Nausea or vomiting, with pain increase following a meal.
  • Fevers and changes in skin color, often a yellowish appearance in the skin.

 

Chronic pancreatitis can have the following symptoms:

  • Persistent attacks over a period of times, usually more than 6 months.
  • Pain radiating from the abdomen to the back.
  • Nausea or vomiting, with pain increase following a meal.
  • Excessive thirst and fatigue.
  • Fevers and changes in skin color, often a yellowish appearance in the skin.
  • Weight loss, in the later stages of chronic pancreatitis, the longer you live with the disease the less likely you have of eating a normal diet because the pain may be too great to eat normally.

 

As you can see it may be difficult to determine which type of pancreatitis is affecting your body just by looking at the symptoms, especially early on. The crucial difference one can make to tell the difference is in the longevity of the pain. Acute pancreatitis starts with a sudden attack of pain that peters out after a few hours to days while chronic pancreatitis remains persistent for months. However, even then that symptom might not be as reliable as it seems. While not well defined recurrent acute pancreatitis has been estimated to occur to roughly 15% of patients who experience a first acute attack. Meaning that although acute is known for only a short sudden burst of pain it is not impossible for it to have chronic-like symptoms in some cases. Another factor to think about is age and sex, it is more common for people between the ages of 40 and 60 to develop chronic pancreatitis with a higher rate of occurrence in the male population which is usually attributed in alcohol consumption. On the other hand women are more likely to have gallstone related pancreatitis.

 

The Difference in Complications

If left untreated or ignored until later on both acute and chronic pancreatitis can develop from mild to serious conditions.

 

Acute pancreatitis may result in a number of issues:

  • Red swollen, tender abdomen
  • Rapid pulse
  • Heart, lung, or kidney failure
  • Pancreatic cell death, or pancreatic necrosis
  • If pancreas begins to bleed, condition could be become fatal

 

Chronic pancreatitis may result in these issues:

  • Diabetes can develop
  • Malabsorption or malnutrition, the diminished ability to secrete enzymes thus leading steatorrhea, bloating, indigestion, dyspepsia, and diarrhea
  • Irreversible scarring of the pancreas, resulting from prolonged inflammation
  • Internal bleeding
  • Intestinal blockage

 

The Difference in Diagnosing

Because acute and chronic have striking similarities in their symptoms the best way to tell is from a diagnosis from a hepatologist.
For acute pancreatitis diagnosing usually begins by looking at one’s medical history, a physical examination, and a blood test (amylase or lipase) for the enzymes in the pancreas. The blood amylase or lipase will usually be elevated 3 times the normal level and that would be a sign of acute pancreatitis. In some cases the blood does not elevate and other measures are taken to diagnosis it such as a CAT scan. After diagnosis is confirmed more tests are run to determine the cause as they will usually vary in how best to treat them. The Pancreas Foundation finds that the most common tools used are transabdominal ultrasound (which can help find gallstones) and computerized tomography (CT) (which is normally used if a patient is experiencing abnormal pancreatic damage).

 

Chronic pancreatitis is more difficult to determine initially with blood tests. Usually they are not used to diagnose it, but can find determine how many pancreatic enzymes are in the blood. A hepotologist may also ask for a sample of your stool for levels of fat, a fatty stool could be a sign that your body is no longer absorbing nutrients properly. Using imaging test is the preferred way to diagnose chronic pancreatitis, usually with Ultrasound imaging, X-Rays, CAT scans, and Endoscopic Retrograde Cholangiopancreatography (ERCP) scans. During the endoscopic scan the doctor will insert a flexible tube into your mouth down to your small intestine. The tube contains an ultrasound probe attached to it that sends sound waves that creates a detailed visual of the pancreas.

 

The Difference in Treatments

In some cases acute pancreatitis can subside within a few days, but it’s recommend to make a doctor’s visit to determine the cause for the illness. People with a mild condition resolves with therapy, while those with a severe condition will need to be treated quickly. Early fluid resuscitation is vital to stop dehydration and insures that blood flow is adequate for the rest of the body, nutritional support that halts nutrition for the first 24 to 48 hours is also necessary, and intravenous medications is used for pain relief. Causes such as gallstones will need a surgical removal.

Unfortunately for those with the chronic pancreatitis the damage to the pancreas cannot be undone, but with the right treatment many of the symptoms can be managed appropriately. Medications that may be prescribed are artificial enzymes if the levels are too low to digest food naturally, pain medication, and dietary changes such as no alcohol consumption and limited amount of fat in the diet. In some cases endoscopy is performed to reduce the pain and remove blockage. The doctor will insert a long flexible tube down the mouth and remove pancreatic stones to improve flow and decrease leaks. Surgery, although not necessary for a lot diagnosed with this disease, can bring welcomed relief to those still experiencing pain despite using medications. Removing part of the pancreas or unblocking the pancreatic duct can be a beneficial pain reliever for severe cases.

 

For Both Cases of Acute and Chronic

 

Acute and chronic pancreatitis may have their fundamental similarities and differences, but one thing that is unquestionably certain for both is looking for a prompt diagnosis and treatment. Whether you believe the symptoms point to acute or chronic both can be life altering and permanently damaging if left untreated. Looking for the difference however still remains an important part to help identify the right treatment options or how best to prevent them. Knowing your family’s medical history for the type of pancreatitis is also a beneficial way to know to stay away from certain foods or drinks or when to go for a consultation with a trusted physician. Looking at the symptoms and determining which pancreatitis you have on your own can be detrimental to your health. Many who categorize it is as acute may tend to ignore more pressing issues because they believe the problem will solve itself within a few hours or days. And while acute pancreatitis can resolve on its own an estimated 80,000 cases of acute pancreatitis are reported each year, with as many as 20 percent of them being severe. The best judgement call is to make a call with your doctor.

If you are interested in learning more about pancreatitis and the differences between acute and chronic, or if you’re experiencing any of the symptoms stated above contact our pancreatic center. Consulting with an experienced hepatologist with knowledge of the stomach and digestive tract can recommend the best treatment options for your individual symptoms.