Both acute and chronic pancreatitis causes inflammation of the pancreas. Although they share some similarities, they are two different conditions. They have different causes and risk factors as well as different treatments.
In this article, we’ll explore acute and chronic pancreatitis. You’ll learn about symptoms, risk factors, diagnosis, and treatment options.
What is the Difference Between Acute and Chronic Pancreatitis?
There are quite a few differences between acute and chronic pancreatitis. Though they both affect the pancreas, the symptoms, treatment, and even diagnosis differ.
Duration
One difference between acute and chronic pancreatitis is its duration. In fact, this is a key difference between the two.
Acute pancreatitis is a sudden, acute bout of inflammation of the pancreas. This usually subsides within a few days or a few weeks.
Chronic pancreatitis is a long-term condition that occurs over many years.
Symptoms
Acute pancreatitis can be mild or a life-threatening condition that requires hospitalization. Symptoms of acute pancreatitis include pain in the upper part of the abdomen and can radiate to the back. The pain becomes worse after eating, coughing, or deep breathing. Leaning forward tends to ameliorate the pain. The abdomen is sensitive to touch, too. Other symptoms include nausea, vomiting, rapid pulse, low blood pressure, and fever.
Chronic pancreatitis also causes abdominal pain. Initially, there are flareups that last a few hours to days. As the disease progresses, the pain becomes constant. The pain also tends to worsen after meals but improves when you lean forward. Other symptoms include unintentional weight loss and oily, foul-smelling stool due to malabsorption.
Diagnosis
The diagnosis of acute pancreatitis considers symptoms, physical examination, and lab tests. These lab tests check the amylase and lipase levels in the body.
Sometimes, doctors require a CT scan of the abdomen. The CT scan can also help evaluate the prognosis.
In the case of chronic pancreatitis, diagnosis requires:
- Physical exam
- CT scan of the abdomen
- MRI
- Ultrasound
- ERCP (endoscopic retrograde cholangiopancreatography)
Sometimes doctors recommend an ERCP as a treatment option as well.
Treatment
The treatment of acute pancreatitis depends on the severity of the symptoms. Mild cases involve a short-term stay in the hospital with IV fluids and painkillers. Individuals will also experience digestive rest with fasting or a low-fat diet.
Moderate cases need longer stays in the hospital. Patients will have IV fluids, feeding tubes, painkillers, and antibiotics in case of infection.
Severe cases can be life-threatening. This stage needs treatment in the intensive care unit to monitor vital signs, urine, and blood tests. If a person is in shock and has very low blood pressure, they’ll receive supplemental oxygen. Doctors may also use a nasogastric tube to remove fluids and air as well.
The treatment of chronic pancreatitis involves pain control with opiates, supplementing pancreatic enzymes, and treating diabetes. Those with acute and chronic pancreatitis should avoid alcohol and smoking. To remove gallstones or scarring, doctors will use ERCP.
About half of those who develop chronic pancreatitis will need surgery at some point.
Complications
There are four main complications those with acute pancreatitis may experience.
The first is the formation of pseudocysts, which is a collection of fluids in or around the pancreas. This can either go away on its own or become infected.
Another complication is the risk of infection of the pancreas. Antibiotics may help resolve this complication.
Damage and death of pancreatic tissue are yet another complication. Medical professionals refer to this complication as necrotizing pancreatitis.
Lastly, organ failure of the lungs, heart, or kidney can be a complication of acute pancreatitis.
A complication of chronic pancreatitis is long-term inflammation of the organ. This leads to scarring and damaged tissue. Many cells that secrete digestive enzymes and pancreatic cells that produce insulin are destroyed in this process. This then causes malabsorption with many nutrient deficiencies and diabetes. Chronic pain, pancreatic pseudocysts, and cancer are also possible complications.
Causes and Risk Factors
Gallstones cause about 40% of acute pancreatitis. Another 30% of cases involve alcohol abuse, which increases your risk of acute pancreatitis. Yet, only a small percentage of those who drink frequently will develop it. This means other factors play a role, such as:
- Angiotensin-converting enzyme inhibitors (ACEIs)
- Diuretics
- Immunosuppressants
- Estrogen therapy
- Smoking
- Viral infections
- Pancreatic cancer
Heavy drinking contributes to about half of the cases of chronic pancreatitis in the US. Smoking is another important risk factor. Genetic disorders and autoimmune pancreatitis play a role in a small proportion of cases. Severe acute pancreatitis can also turn into chronic pancreatitis.
In some cases of both acute and chronic pancreatitis, doctors cannot identify the exact underlying cause.
Acute vs. Chronic Pancreatitis
Which is worse: acute pancreatitis or chronic pancreatitis?
With most cases of acute pancreatitis, doctors can treat it successfully. The most important thing is to identify and address the underlying cause. However, severe cases can complicate and become life-threatening.
More serious complications occur with chronic pancreatitis. This is due to the inflammation and damage of the pancreatic tissue. The result is scarring and loss of healthy tissue. Those with chronic pancreatitis experience debilitating pain, severe malnutrition, and pancreatic cancer. Chronic pancreatitis is also more likely to lead to death compared to acute pancreatitis.
It’s best to avoid risk factors such as drinking and smoking if you have concerns about the condition. If you suspect you have acute or chronic pancreatitis, see your doctor to get tested.
