Finding out about pancreatitis can be a challenge in itself, and often needs a fair bit of diagnostics. Too many other options come with the same clinical signs, and the elusive organ does not easily show its problem. Even the specific test for pancreatitis can give us misleading results, with accuracy of around 70% only. This means that in order to obtain the diagnosis, several tests are required to get a complete picture and rule out the differentials. Commonly, we will run a full blood check and an abdominal ultrasound scan, but even x-rays or repeated blood tests can be indicated. 

And once we know what we are dealing with, the next challenge awaits. The pancreas, once upset, will easily react to oral medication – meaning it tends to get worse rather than better. The best approach of treatment is hospitalisation, iv fluids, injectable medication and very very very strict diet.

Diet is a key factor in this, as a full stomach will signal the pancreas that ‘we have something to digest, we need your enzymes’, and an upset pancreas will not like that kind of challenge. Instead of providing the enzymes into the gut, where they are needed, it tends to start digesting itself and its surrounding fatty tissue, a very harmful and hugely painful procedure! To avoid this, we try to keep the stomach empty, so that it won’t send the signal. This means tiny bite size meals every hour, very low fat, to never trigger a ‘hey, we need you to digest’ response and give the pancreas a chance to calm down and heal.

Full recovery is possible and prognosis is generally good, unless there are underlying factors present (ultrasound scan is used to search for those). Recovery, however, tends to be slow, and response to treatment can take many days. Patience is required, and while some can go home after 3 or 4 days, others may end up staying in hospital for a few weeks before they are ready to go home. 

Once the pain levels and severe nausea are under control, and Beany takes his bite size meals, he can go home and continue nursing care with his family. But beware, pancreatitis has a high incidence of relapse. Continue the feeding instructions to the letter to avoid another flare up at home!