Pancreatitis Treatments and Medications

Abdominal pain, nausea, fever, and weakness can be challenging symptoms to deal with. These are just some of the symptoms that characterize pancreatitis. Understanding what pancreatitis is and how to treat it both are great first steps toward managing symptoms.

What is pancreatitis?

Pancreatitis is an inflammation of the pancreas, a gland that’s behind the stomach in the upper part of the abdomen. When digestive enzymes in the pancreas become activated, this causes inflammation and scarring. Over 200,000 people in the United States experience pancreatitis every year.

Pancreatitis can be either acute or chronic. Symptoms of both types of pancreatitis include abdominal pain, nausea, fever, a rapid pulse, weight loss, a swollen abdomen, and diarrhea. Treatment will depend on the severity and type of pancreatitis but it often involves hospitalization. Acute pancreatitis may be treated within several days or weeks, but chronic pancreatitis may last a lifetime.

How is pancreatitis diagnosed?

Pancreatitis happens when the pancreas becomes inflamed as digestive enzymes begin to digest pancreatic tissue. This can cause severe pain in the abdomen, nausea, and fever. Risk factors for pancreatitis include having a family history of the condition, drinking excessive amounts of alcohol, smoking, having high levels of triglycerides, trauma to the abdomen, and gallstones.

If you have symptoms of pancreatitis, your doctor will likely perform a series of tests to diagnose pancreatitis and determine what’s causing it. A blood test will show whether or not there are excessive amounts of the digestive enzymes amylase and lipase, which indicate pancreatitis.

An endoscopic retrograde cholangiopancreatography (ERCP) can show if any bile ducts are obstructed. Imaging tests like CT scans can show gallstones and inflammation in the pancreas. Even ultrasounds can help diagnose pancreatitis. The type of test a physician or gastroenterologist runs may vary depending on the person and the individual symptoms.

During a hospital stay or trip to the doctor’s office, you might be asked some of the following questions to help determine whether or not you have pancreatitis:

• When did your symptoms first start?

• Do you have a family history of pancreas disease?

• Do you drink alcohol? How often and how much?

• Do you smoke? How long have you smoked?

Pancreatitis treatment options

Acute and chronic pancreatitis will likely require different treatment methods. “Acute pancreatitis is treated with supportive care, the most important of which are controlling pain using a variety of different medications...and intravenous (IV) fluids to correct dehydration and blood work/electrolyte abnormalities,” says Taylor Graber, MD, an anesthesiologist with ASAP IVs, and the University of California, San Diego.

With severe pancreatitis, patients are not allowed to eat or drink because of the increased risk of gastric obstruction and worsening pain. However, with mild pancreatitis, "the patient is encouraged to eat and drink normally, as a quicker return to normal eating can hasten recovery," explains Dr. Graber. "Most patients with mild acute pancreatitis recover within 3-7 days without further treatment or therapy. A smaller portion of patients (~20%) will develop moderate to severe pancreatitis, rarely progressing to transient and persistent organ failure, and may need further admission to an intensive care unit for monitoring and treatment.”

For people who develop chronic pancreatitis, treatment will likely involve daily doses of pain medications, vitamins, pancreatic enzymes that help digest food, and potentially insulin to help with blood sugar levels.

Pancreatitis medications

Antibiotics and pain medications are the most popular treatments that doctors prescribe for people with pancreatitis. The type of medication prescribed will depend on the individual, symptoms, medical history, and response to treatment.

Antibiotics

For severe pancreatitis, antibiotics may be required to get rid of an infection in the pancreas, which is present in up to 20% of cases. Patients without an infectious etiology of pancreatitis, should not be given prophylactic antibiotics. Omnipen (ampicillin), Primaxin Iv (imipenem/cilastatin), and Rocephin (ceftriaxone sodium) are commonly prescribed for pancreatitis and require a prescription. Antibiotics may cause diarrhea, allergic reactions, or difficulty breathing.

Pain medications

Pancreatitis can be very painful and most people will take some form of pain medication to help with their symptoms. Some pain medications like acetaminophen (Tylenol) are available over the counter, and others like Demerol (meperidine HCL) and Ultram (tramadol HCL) require a prescription. Pain medications may cause side effects like dizziness, allergic reaction, or confusion. Tylenol should be avoided if there is liver damage present.

Choosing the best medication

There is no one universal pancreatitis medication that’s best for everyone. Individual symptoms and responses to treatment vary. A doctor can determine the best medication for pancreatitis based on an individual’s symptoms, medical history, and response to treatments. Here’s an overview of popular medications that a doctor may prescribe.

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Best medications for pancreatitis