Pancreatitis

Relieving Your Discomfort, Improving Your Life

Pancreatitis is inflammation of the pancreas. It can be very painful and even life-threatening. Acute pancreatitis is short-term and resolves with intensive treatment. Chronic pancreatitis occurs over a longer period of time and requires specialized treatment as well. At NewYork-Presbyterian, our pancreatic disease experts have a wealth of experience treating both types of pancreatitis, offering in-hospital support, surgery-free therapies, and long-term treatment regimens to reduce inflammation and pain and restore your quality of life.

Causes of pancreatitis

Pancreatitis may be caused by:

• Alcohol abuse
• High calcium blood levels (hypercalcemia)
• Elevated triglyceride levels
• Gallstones
• Genetic causes, such as gastric fibrosis
• Injury to the abdomen
• Severe viral or bacterial infection
• Some medications, such as estrogen supplements and some diuretics (water pills)
• Structural problems of the pancreatic and bile ducts

Pancreatitis Signs & Symptoms

Symptoms of acute pancreatitis may include:

• Abdominal bloating and tenderness
• Clammy skin
• Jaundice (yellowing of the skin and whites of the eyes)
• Lower blood pressure
• Low-grade fever
• Nausea/vomiting
• Severe, steady pain in the upper/middle part of the abdomen, which often radiates into the back

Chronic pancreatitis may cause:

• Nausea/vomiting
• Onset of diabetes mellitus
• Pain in the abdomen and/or back
• Pale colored, oily stools
• Unexplained weight loss

Diagnosing Pancreatitis

The diagnosis of pancreatitis may require the use of specialized techniques not widely available at many hospitals. We offer all of these approaches at NewYork-Presbyterian, and our pancreatic care teams are exceptionally experienced in using them. In addition to standard imaging tests such as CT, MRI, and abdominal ultrasound, we use:

• Endoscopic ultrasound (EUS). An interventional endoscopist uses a special endoscope with high-energy sound waves ("echoendoscope") to see your pancreas and the pancreatic duct.
• Endoscopic retrograde cholangiopancreatography (ERCP). This technique combines endoscopy and x-rays to provide a clear image of the structure of your pancreas and can show any abnormalities, as well as identify if gallstones are causing your pancreatitis. NewYork-Presbyterian’s interventional endoscopists routinely perform this procedure and are highly regarded experts in its use.
• Pancreatic function test. We use this endoscopic test to assess the production of secretin, a hormone produced by the small intestine that stimulates the pancreas. Reducing stimulation of the pancreas helps to relieve pancreatitis pain.

Our Approach to Care

Pancreatitis can become severe and therefore requires a team of experts to accurately diagnose it and treat it successfully. Your treatment team includes gastroenterologists, surgeons, interventional endoscopists, radiologists, award-winning nurses, registered dietitians who provide dietary guidance, and others with the experience and compassion to provide all the care you need. We also host a special support group for patients who are currently being treated for pancreatitis.

How we treat pancreatitis

At NewYork-Presbyterian, your team tailors your treatment to your individual medical needs. Your treatment depends on whether your pancreatitis is acute or chronic, and how severe it is.

Intravenous hydration and nutritional support. To allow your pancreas to recover and to prevent damage and irritation, you may need to temporarily receive intravenous fluids for hydration. Some people cannot eat regular food and receive "enteral" nutrition through a feeding tube. We may also recommend a low-fat nutritious diet and prescribe enzyme supplements.

ERCP to insert a stent (small tube) to open a blocked bile or pancreatic duct; perform sphincterotomy (a tiny cut to enlarge a duct opening); perform balloon dilatation (insertion of a balloon to open a narrowed duct); or remove or destroy a gallstone using laser or shock wave lithotripsy. Our doctors can also remove dead pancreatic tissue endoscopically.

Relief of chronic pancreatitis pain. If you have severe pain due to pancreatitis, you may undergo an EUS-guided “celiac plexus block.” Also called neurolysis, this treatment is a form of local anesthesia that we offer to relieve severe or chronic abdominal pain. We also use oral medications and pain pumps implanted in the spine to control chronic pain. Our pain medicine specialists work with you to put together a pain management plan that meets your medical needs and personal preferences.

Surgery. When other treatments are not effective enough to control your pain, you may need surgery such as total pancreatectomy (removal of all of the pancreas). This procedure is reserved only for those with pancreatitis in whom the pain is so severe and unrelenting that it has led to a dependence on narcotic medications and all other treatments have failed.

Islet cell transplantation. Removal of the pancreas causes type 1 diabetes; to treat the pain of chronic pancreatitis but reduce the risk of developing diabetes after surgery, NewYork-Presbyterian/Columbia University Irving Medical Center offers total pancreatectomy and "autologous islet cell transplantation" — an innovative process of removing your own insulin-producing islet cells and reinjecting them into your liver after pancreatectomy. This treatment may allow you to retain some of your insulin-producing function and avoid diabetes. A third of patients can maintain normal blood sugar levels without needing insulin therapy, while another third can significantly reduce their dependence on insulin injections.

Why Choose Us

Pancreatitis is a complex disease that can cause debilitating pain and discomfort. It's treatment can be quick or lengthy, depending on what type of inflammation is present (acute or chronic). NewYork-Presbyterian has a highly experienced team completely dedicated to the care of patients with pancreatitis. Our programs offer the most advanced diagnostic tests and minimally invasive treatments to help people with pancreatitis live more comfortable lives. We are also a world leader in islet cell transplantation, becoming the first center in the New York metropolitan area and one of just a few in the country to offer this procedure. Come to where the leaders are. Call us today for an appointment.