Causes

In general, most medical websites that list causes for pancreatitis agree on relative percentages of causes. They list these, but in no particular order, and not well ordered. I have gathered these and used the same terminology.

Acute Pancreatitis
Prolonged Alcohol Use35%Recurrrance: 50%
Gall Stones45%Recurrance: 50%
Idiopathic10%strong indications of a mutation in cystic fibrosis transmembrane conductance regulator (CFTR) gene - between 20-40%
Other10%Medications, Trauma to abdomen, Surgery
Chronic Pancreatitis
Prolonged Alcohol Use70% 
Idiopathic20%strong indications of a mutation in cystic fibrosis transmembrane conductance regulator (CFTR) gene - between 20-40%
Other10%Tropical, Hereditary, Hyperparathyroidism, Cystic Fibrosis, Pancreas Divisum

While not common, Acute Pancreatitis can lead to Chronic Pancreatitis. Someone with Chronic Pancreatitis can have an Acute Pancreatitis attack.

The main difference between Acute Pancreatitis and Chronic Pancreatitis is based on the damage to the pancreas. With Chronic Pancreatitis, the damage is irreversible.

Acute Pancreatitis is life-threatening. The mortality rate of those with Acute Pancreatitis that are hospitalized is between 20% and 30%. More research projects use the 20% rate, one uses 30% rate.

There are research papers that show 13% of patients undergoing ECRP for diagnostic purposes end up with Chronic Pancreatitis. ECRP was originally designed as a diagnostic tool on those with pancreatitis and with jaundice. ECRP was used to diagnose pancreatic cancer.

I read in pancreatitis forums and pancreatitis support pages on Facebook about the confusion involving Chronic Pancreatitis. Chronic Pancreatitis (CP) is not a severe form of Acute Pancreatitis (AP). It is the other way around. Acute Pancreatitis is life-threatening with a mortality rate of 30% if hospitalized with an extended stay (over three months). It is important that you communicate the correct diagnosis to the medical community. For example, if you require a visit to the Emergency Room and you tell them you have pancreatic pain and your diagnosis is AcutePancreatitis, you will likely be admitted and put on intravenous to give your pancreas a rest and opportunity to heal. This also helps peripheral organs and protects them from further inflammation caused by the AP. In the same circumstances with CP, you will likely get sent home (likely after some pain meds) -- and could cause some serious problems and complications if you really have AP.

The cause of your pancreatitis is important. If your doctor is unsure, has not told you the cause, or you are diagnosed Idiopathic: accept the diagnosis and move on. It is far more important for you to learn how to live with pancreatitis than it is trying to find cause or blame. There are things you can to do minimize inflammation and changes you can make to lifestyle that can help you live as close as possible to a normal life.

Resources:
National Pancreas Foundation
Hereditary Pancreatitis
Cleveland Clinic Pancreatic Disorders
American College of Emergency Physicians
History of Pancreatitis

Comments

Found that it is thought that after gallbladder surgery that many suffer from what is named "SOD" Sphincter of Oddi dysfunction that causes elevations in liver enzymes from a spasm if the sphincter, but after experiencing several attacks of these upper abdominal acute attacks and developing symptoms consistent with both pancreatitis and hepatitis, it was determined that these were actually biliary stones that were passing from either the pancreas or the liver (intrahepatic stones),they feel similar to kidney stones but burn and ache up into the chest until they pass, sometimes confused with chest pain, with nausea then after passing into small intestine, follow with diarrhea and pancreatic and hepatic pressure for days sometimes weeks, leaving you suggish and ill for a time afterwards. I have only had one of these stones seen on scan and it was before my gallbladder was removed (had several CCK hida scans with no noted stones). Many have Chronic pancreatits and don't understand the symptoms and are treated for GERD, and heartburn for many years until they develop acute pancreatitis as I did.

Posted by Diane Allen on January 26, 2014, 7:37 pm

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