Symptoms Of Pancreatitis: 11 Warning Signs Of Pancreatitis

Pancreatitis is the inflammation of the pancreatic tissue, which arises as a result of cellular injury to the pancreas. When the cellular membrane goes out of control, the pancreas starts activating enzymes and substances that attract inflammatory cells and precipitate a very dangerous disease. The severity of pancreatitis is variable in each patient, and even though mild cases are very simple to treat, severe pancreatitis requires intensive care and may also need a surgical procedure. Thus, it is important to recognize the signs and symptoms associated with pancreatitis so we can have a clear idea of how this ailment affects patients and when is it recommended to search for medical health.

In this article, you will find the most important signs and symptoms associated with pancreatitis. If you suspect a case of pancreatitis in yourself or someone else, look for medical assistance right away because recognizing these patients as soon as possible is one of the keys to a successful therapeutic approach.

Abdominal pain

Abdominal pain is regarded as the cardinal symptom of pancreatitis, the most important to guide clinicians into a diagnosis. It is usually a dull pain located in the middle of the upper abdomen and radiated to the back. It appears suddenly and becomes worse as time goes by. In the end, patients describe this abdominal pain as a constant and severe ache that becomes even worse after meals.

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Pain in pancreatitis is caused by various factors, especially the obstruction of blood flow to the cells of the pancreas and the systematic destruction of the nerves in the organ. There is ischemia of the tissue and several local changes with severe inflammation that activates nerve terminals and triggers neuropathic pain.

Muscular guarding

Pancreatitis creates a severe inflammatory state in the organ that extends to its surrounding. When the inflammatory mediators reach the internal linings of the abdominal cavity (the peritoneum), the muscles of the abdominal wall become tense around the inflamed area. This is also known as muscular guarding, and it is detected in the physical exam as a difference in muscle tension around the painful area.

It might be a bit difficult to detect muscular guarding and differentiate this symptom from the ordinary muscular defense reflex people would have when touching a tender area. This symptom is common in almost any inflammatory condition of the abdomen, including pancreatitis, diverticulitis, ectopic pregnancy, and many others.

Fever

It is present in up to 76% of cases of pancreatitis, and it is usually associated with tachycardia, an accelerated heartbeat. Fever does not mean there’s an infection in the pancreas or any other part of the body, and antibiotic therapy is not recommended as a routine therapy of pancreatitis.

Thus, if you experience fever do not automatically believe it is caused by an infection. Instead, it is the inflammatory state triggered by pancreatic damage that increases body temperature through activating the thermoregulatory regions in the brain. Hypotension is usually noted along with fever and accelerated heartbeat, and along with the rest of the symptoms, they provide a general scope to diagnose this disease.

Nausea and vomiting

Patients with severe nausea and vomiting plus abdominal pain in the upper portion of the abdomen should be immediately screened for pancreatitis. Nausea and vomiting are both very common in this ailment, which affects the normal gastrointestinal function and creates an inflammatory state that triggers nausea and reduces bowel movements.

In patients with pancreatitis, there is an obstruction to the normal propulsive ability of the intestines, which is clinically named ileus. Similar to what happens in intestinal obstructions, the reduction of intestinal transit slows down the function of the stomach and makes patients feel sick, triggering vomiting as well.

Bloating and indigestion

Pancreatitis affects the normal gastrointestinal function obstructing the intestinal transit, an ileus in the stomach and the intestines, nutrient absorption problems, and imbalances in the levels of acidity in the gastrointestinal tract. Altogether, all of these factors contribute to a feeling of indigestion and bloating after eating. Most patients report a dull and continuous abdominal pain that exacerbates closely after eating their meal. These patients are often found with abdominal distention in up to 65% of cases.

Bowel irregularities

The normal bowel movement is one every day, but it depends on each patient. In pancreatitis, besides having the symptoms we have described above, patients often have bowel irregularities that might be translated into diarrhea or constipation. Diarrhea typically results from nutrient absorption problems, especially related to impaired absorption of fatty acids. Thus, diarrhea is often greasy and foul-smelling.

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However, instead of diarrhea, some patients would experience constipation instead, which results from an inflammatory reaction in the intestinal traffic to the inflammatory condition created by pancreatitis. As we have mentioned previously, there’s ileum, a type of obstruction to the normal propulsive ability of the gastrointestinal tract, which may result in constipation. In most cases, diarrhea is seen in chronic pancreatitis while constipation is more common in acute pancreatitis.

Loss of appetite

Patients with pancreatitis have several factors contributing to reducing their perceived sense of hunger. One of them is nausea and vomiting, which becomes even worse after eating and keeps patients away from large meals. Abdominal distention, bloating, and abdominal discomfort contributes to this problem, and pain aggravates after eating as well. Since there is a reduction in the normal movements of the intestines, gastric emptying is also reduced, and these patients often take a very short time to feel satiated and a very long time to feel hungry once again.

Weight loss

Pancreatitis can be either acute or chronic. Acute pancreatitis is more severe and life-threatening and appears suddenly with alarming signs and symptoms. Chronic pancreatitis has a slower progression, and the symptoms are not unbearable. Severe pain is intermittent and transient, lasting for a few hours. However, the gastrointestinal alterations remain for a very long time, which is why these patients commonly reduce their weight without planning.

Weight loss in chronic pancreatitis results from an alteration in the absorption of nutrients and diarrhea. As a result, these patients have a reduced energy intake, and they may even have several nutritional deficiencies. There is also an increase in metabolic activity and energy expenditure as a result of the ongoing stress affecting the organism. Dietary modifications and alcohol abstinence are required for patients to maintain a healthy weight, and in most cases, oral supplementation of vitamins might be required. However, it is important to follow instructions from your doctor to avoid consuming supplements you don’t really need and might even aggravate your symptoms.

Jaundice

Some patients with pancreatitis exhibit jaundice as well. Even though it’s not the majority of patients, they are around 30%, especially those who display gallbladder problems. In most cases, it is a gallbladder stone that gets stuck in the bile duct just before its opening to the intestines, and these patients display symptoms from a gallbladder obstruction and pancreatitis as well. When this happens, both the bile and the pancreatic juice flow backwards to the gallbladder and the liver, or the pancreas respectively. The bile returns to the blood increases our circulating levels of bilirubin and causes a yellowish coloration to the skin while the pancreatic juice stays for a long time in the pancreas, their enzymes are activated and starts digesting the organ and triggering pancreatitis.

Patients with jaundice and pancreatitis signs should be attended immediately in the emergency room. They often have a very rapid course of severe pancreatitis, and their abdominal pain becomes unbearable with vomiting and fast dehydration. Thus, it is important to look for medical assistance right away to prevent the fatal outcomes of this disease.

Respiratory problems

A few patients with pancreatitis would also experience respiratory symptoms. The pancreas is close to the diaphragm, the most important muscle of respiration, and the one that separates the abdominal cavity from the thorax. The inflammation of the pancreatic tissue starts irritating the diaphragm and goes through this muscle to trigger inflammation in the lungs and the adjacent organs. Many of these patients have pleural effusion or free liquid in the virtual space that separates the outer lining of the lungs and the inner lining of the thorax. Liquid in this space leads to an abnormal hermetic pressure that impairs the normal respiratory movements of the diaphragm.

Some patients would even develop a serious condition called acute respiratory distress syndrome, which typically results from the liquid in the air sacs of the lungs, which does not allow for a proper exchange between oxygen and carbon dioxide in the lungs. In cases of respiratory symptoms, patients would also have an abnormally accelerated breathing, and they should be promptly assessed to prevent a serious complication.

Bleeding

One of the most feared complications of pancreatitis is hemodynamic instability. Luckily enough, it does not appear in more than 10% of patients, but it is a severe problem that may turn pancreatitis into a life-threatening disease. These patients may have hematemesis (the clinical name for vomiting blood) or melena (blood in their feces).

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These patients with blood loss are usually pale and have anemia (low levels of red blood cells). In very severe cases, patients may display a bluish color around the belly button or a reddish color running along the flanks when there is an internal hemorrhage in the abdominal cavity.