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Prevention, Early Detection, and Treatment

Pancreatitis demands prompt medical attention. During an acute attack, there is the potential for the pancreas to be severely damaged within a matter of hours and complications can be life-threatening.

Acute Pancreatitis
It is not possible to prevent attacks of acute pancreatitis attacks or to detect them early.

Patients are admitted to hospital. Treatment consists of pain control until symptoms subside and "resting" the pancreas for several days to a few weeks by giving all fluids and nutrition either enterally or intravenously (IV) depending on the severity of the inflammation. If the acute pancreatitis is due to gallstones, surgery may be needed to remove the gallbladder at a later date. If an infection is identified, antibiotics should be started but prophylactic antibiotics are not recommended in patients with acute pancreatitis, regardless of the type or disease severity.

Chronic Pancreatitis
Chronic pancreatitis is treated by trying to prevent future attacks to minimize further pancreatic damage, and by providing treatment for damage already done. Abstention from alcohol is critical in helping to prevent additional attacks. If there is evidence of impaired fat absorption, a low fat diet may be prescribed and pancreatic enzymes may be given by mouth. The patient may also need to supplement fat-soluble vitamins. Glucose intolerance or pre-diabetes state occurs with some frequency in chronic pancreatitis, but diabetes mellitus usually occurs late in the course of disease. A trial of oral antidiabetic drugs followed by insulin therapy is commonly used in these patients.

Analgesics are an important part of treatment as patients often have persistent moderate to severe pain. Some need treatment for depression. As time progresses and pancreas function diminishes, the pain level may drop.

Surgery may be necessary to relieve obstructions to the pancreatic or biliary ducts and sometimes to remove part or the entire pancreas. It should be noted that the pancreas is very difficult to operate on and requires a surgeon experienced in pancreatic surgery.

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