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Pancreatitis

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Pancreatitis occurs when the pancreas becomes inflamed, and can be fatal. This disease can be caused by certain type 2 diabetes medications like Januvia and Byetta.

Pancreatitis afflicts the pancreas, the organ responsible for excreting digestive juices and insulin to control blood sugar. It can lead to pancreatic cancer, one of the most deadly cancers. The pancreas normally helps digestion by secreting enzymes. Pancreatitis occurs when these enzymes start digesting the pancreatic tissues instead of traveling to the small intestine to digest food.
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There are two types of pancreatitis: acute and chronic. Both are serious, and both can be fatal.
Acute pancreatitis occurs suddenly, and if treated in time, usually resolves within a few days. Almost a quarter of a million Americans suffer from acute pancreatitis each year.
Chronic pancreatitis does not heal or improve. This type of pancreatitis usually gets worse over time and causes permanent damage.
There are several causes of acute and chronic pancreatitis. Doctors use a wide variety of tests to diagnose these diseases. Treatments for the two types of pancreatitis differ slight because the acute variety is curable, whereas chronic pancreatitis gets worse with time. It’s important to note, however, that acute pancreatitis can more quickly cause organ damage or death.

Pancreatitis Causes

For acute pancreatitis, the most common cause is the formation of gallstones that cause inflammation as they pass through the bile duct.
Other causes of acute pancreatitis include:
Frequent, heavy alcohol use Abdominal trauma
Tumors Infections
Genetic abnormalities Certain medications
Unfortunately, some medications used to treat type 2 diabetes may also increase the risk of acute pancreatitis.
Some of these drugs include:
Byetta Januvia
Onglyza Victoza
A number of people who were diagnosed with pancreatitis or pancreatic cancer after taking these drugs filed lawsuits against the drugs’ manufacturers. Chronic pancreatitis usually develops in a patient between the age of 30 and 40. The most common cause of this type of pancreatitis is chronic, heavy drinking. Certain conditions like diarrhea and abdominal pain that last several days and reoccur over time may eventually progress to chronic pancreatitis.
Other causes of chronic pancreatitis include:
Hereditary disorders High levels of calcium in the blood (hypercalcemia)
High levels of fat in the blood (hypertriglyceridemia) Some medications
Cystic fibrosis Autoimmune disorders

Pancreatitis Symptoms

The symptoms of acute and chronic pancreatitis are slightly different, but both usually involve severe abdominal pain, vomiting and nausea.
With acute pancreatitis, commons symptoms include:
Swollen or tender abdomen Nausea
Vomiting Fever
Tachycardia (rapid heartbeat)
The abdominal pain may linger for several days and is often severe. People suffering from acute pancreatitis need immediate medical attention because the disease can cause dehydration, low blood pressure, organ failure and death. The symptoms of chronic pancreatitis are similar to those of acute pancreatitis, in that upper abdominal pain is a common symptom. The pain can spread to the back and become worse after eating or drinking. In some cases, however, people with chronic pancreatitis may not have any pain.
Other symptoms of chronic pancreatitis may include:
Nausea Vomiting
Oily stools Weight loss
Diarrhea
Weight loss occurs in chronic pancreatitis because the pancreas no longer produces enough digestive enzymes to absorb nutrition from food, and a good deal of fat leaves the body in the stool. In chronic pancreatitis, the damage to the pancreas is slower than in acute pancreatitis. When symptoms first emerge, patients should seek medical attention to rule out acute pancreatitis or pancreatic cancer, because chronic pancreatitis has symptoms close to those of pancreatic cancer. The symptoms of chronic pancreatitis are ongoing and often reoccur but cannot be cured. People with chronic pancreatitis often require treatment for the rest of their lives.

Diagnosing Pancreatitis

Diagnosing pancreatitis is difficult because the pancreas is hidden behind other organs.
To diagnose pancreatitis, a doctor may order one or more tests:
Abdominal ultrasound. This technology uses sound waves that bounce off the pancreas and create a picture on a video monitor. It can also detect gallstones that may be causing inflammation.
Endoscopic ultrasound (EUS). In this test, a doctor passes a thin, flexible tube down the throat, into the stomach and into the small intestine to check the pancreas and bile ducts.
Computerized tomography (CT). This is a non-invasive test similar to an X-ray that shows gallstones and may detect damage to the pancreas.
Abdominal X rays . Using X-rays, doctors can check for any damage to the pancreas.
  Along with these tests, doctors can do blood tests to check for elevated levels of digestive enzymes in the blood. In addition, the levels of magnesium, potassium, sodium, calcium, bicarbonate and glucose may change, and a blood test will be able to detect these fluctuations.

Treatments for Pancreatitis

Treatment for acute pancreatitis must be administered as soon as possible and involves staying at the hospital for a few days. Fluids are administered intravenously (IV), along with antibiotics and pain relievers. During recovery, no eating or drinking is allowed, in order to reduce strain on the pancreas and allow it time to heal. In severe cases, doctors may insert a feeding tube to deliver liquid nutrition to the stomach. Doctors do not advise smoking, eating fatty foods or drinking alcoholic beverages in order to prevent the return of pancreatitis. Those with chronic pancreatitis may require synthetic enzymes to help digest the food, since in many cases the pancreas no longer secretes enzymes. They also require ongoing care to manage the slow damage to the pancreas and minimize symptoms. To treat recurrent upper abdominal pain, over-the-counter pain medications can be used. In some more severe cases, doctors will prescribe narcotics. Injections called nerve blocks can also stop the pain signals coming from the pancreas. People with chronic pancreatitis should also stay away from alcohol. In the worst cases, doctors will surgically clear blocked pancreatic ducts in a procedure called a pancreaticojejunostomy. This alleviates pressure and pain. Removing part of the pancreas can also help with pain.

Diabetes Medications and Pancreatitis

A number of published studies link type 2 diabetes medications called incretin therapies to a greater risk of developing pancreatitis. The U.S. Food and Drug Administration (FDA) recently strengthened the warning labels on these drugs to warn about the risk of acute pancreatitis. The FDA also says that these medications should not be used in people with a history of the disease. One study published in 2013 in the Journal of the American Medical Association showed that people who took incretin therapies have double the risk of being hospitalized for acute pancreatitis. In another article, published in Diabetes Care, the authors "strongly discourage" the use of both GLP-1's and DPP-4's, two kinds of incretin therapies, together because of the increased pancreatitis risk. Despite the information available on pancreatitis risk, the FDA continues to regard pancreatitis as a minor concern with these therapies. Its position remains that the benefits outweigh the risks.