Pancreatitis needs attention

Q. My son, who is in his late 50s, had perfect health all his life. Now, suddenly, he has developed what his doctors call "pancreatitis."

More than a year ago, he started having attacks of incapacitating, excruciating abdominal pain about every two weeks. Each attack lasts a few days and then goes away.

He has no health insurance and waited a long time before seeing a doctor. He was told that he needed gallbladder removal because the doctor was 98 percent sure that this was the problem. However, after having the surgery, the attacks returned every two weeks, exactly as before.

A. Pancreatitis is inflammation of the pancreas (a gland that produces digestive juices, insulin and glucagon). There are two types of pancreatitis - acute and chronic - both of which can be life-threatening.

Acute episodes usually come on suddenly and disappear after a few days with treatment. During an episode, the digestive juices attack the pancreas, leading to tissue damage. Most cases are the result of gallstones. Other causes can include chronic alcoholism, infections, tumors, genetic pancreatic abnormalities, medications and abdominal trauma.

Symptoms during an acute attack may include upper-abdominal pain, swelling and tenderness, fever, nausea, vomiting and an increased pulse.

Treatment includes hospitalization for intravenous fluids, antibiotics and pain medication. It is also important not to eat or drink during the attack to allow the pancreas time to rest and heal. If vomiting is present, it may be necessary to remove fluid and air from the stomach with a naso-gastric tube, which may need to stay in place for several weeks.

Chronic pancreatitis is so named because the pancreas does not improve or heal, eventually leading to permanent damage. It is usually the result of severe, chronic alcohol abuse.

Treatment is similar to that of the acute form and includes hospitalization, IV fluids and so forth. However, the after care is different. Consultation with a dietitian may be beneficial to devise a meal plan that is low in fat.

I urge your son to be seen by a specialist who can test and diagnose him. It is vital that the reason behind the repeated attacks is found before serious damage occurs, if it has not already.

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