Sharp abdominal pain is a symptom of inflammation in the pancreas, which can be an acute (short-term) or a chronic (recurring) condition.
Located behind the stomach, the pancreas has role in converting food into fuel. The tubeshaped organ secretes powerful digestive enzymes into the small intestine to break down carbohydrates, proteins and fat. It also releases two hormones, insulin and glucagon, into the bloodstream to ‘digest’ sugar.
The pancreas can become inflamed due to several reasons.
One of the most common is alcohol abuse. Alcohol changes the composition of proteins secreted by the pancreas. This causes protein ‘plugs’ to form and block the pancreatic ducts, leading to swelling. Pancreatitis can also be caused by the formation of gallstones, certain medications and – rarely – infections, trauma or surgery of the abdomen.
Acute or chronic?
Inflammation of the pancreas can be acute or chronic.
Acute pancreatitis refers to an isolated and short-term episode, and symptoms include a sharp upper abdominal pain that travels through the back that may be aggravated by eating. The abdomen may swell and be tender to the touch. It can be treated with supportive management of pain and intravenous fluids. In a small percentage of cases, severe pancreatitis can lead to failure of other organs, such as the heart, lungs or kidneys. In these cases, surgery may be needed to remove parts of the gland that have been irreversibly damaged. Acute pancreatitis can also lead to chronic pancreatitis. Chronic pancreatitis is a long-term disease. The inflammation may no longer be active, but the damage has been done and flare-ups could recur. In chronic cases, the pancreas develops scar tissue called fibrosis, calcium deposits and inflammation of its ducts.
Chronic pancreatitis can lead to serious complications, such as loss of pancreatic function leading to an inability to absorb nutrients. Damage to the insulin-producing cells in the pancreas may also lead to diabetes. In fact, almost half of those with chronic pancreatitis will develop diabetes.
Chronic pancreatitis can be challenging to treat. The goal is to relieve pain and make up for loss of function. To improve nutrition and address metabolic problems, patients may be given pancreatic enzymes and insulin. In some instances, surgery may be needed to remove blockages of the pancreatic ducts.