Pancreatitis: What Is It & What Causes It?

Thousands of Americans develop pancreatitis every year – and the disease can be fatal in certain situations. However, it is often referred to generically and can be misunderstood. So, what is pancreatitis and what causes it?

Pancreatitis: What is it?

Pancreatitis is the inflammation or infection of the pancreas. The pancreas, a gland located behind the stomach, releases the hormones insulin, glucagon and substances that help with digestion.

There are several types of pancreatitis – including acute pancreatitis, chronic pancreatitis and pancreatic abscess. Here's a bit more on each:

• Acute pancreatitis. Acute pancreatitis is the general swelling or inflammation of the pancreas. The main symptom of acute pancreatitis is abdominal pain which is typically felt in the upper left side or middle of the belly area or abdomen. Treatments include pain medications, fluids given by IV or by withholding food or fluids by mouth.
• Chronic pancreatitis. Chronic pancreatitis is the general swelling or inflammation of the pancreas that is chronic in nature and may lead to scarring and loss of function. Treatments include analgesics or surgical nerve block to relieve pain, eating a low-fat diet, getting enough vitamins and calcium in the diet, taking insulin to control blood sugar (glucose) levels and taking pancreatic enzyme supplements. Surgery may be required to remove a blockage and all or parts of the pancreas may have to be removed in severe cases.
• Pancreatic abscess. A pancreatic abscess is a cavity of pus within the pancreas. It may be possible to drain the abscess through the skin (a procedure known as percutaneous). However, surgery to drain the abscess and remove dead tissue may be required – and the death rate for those who do not have the abscess drained is high.

What causes pancreatitis?

Pancreatitis can be caused by a variety of things – some naturally occurring and others which aren't. Naturally occuring causes include:

• Abnormal pancreas structure
• Gallbladder disease
• Complications of cystic fibrosis
• Genetics factors
• High blood lipid levels (hypertriglyceridemia)
• Pancreas surgery
• Injuries & infections

Non-naturally occurring causes include:

• alcohol use
• prescription drugs such as estrogens, corticosteroids, thiazide diuretics, azathioprine and sitagliptin (also known as Januvia and Janumet)

It's the latter that has angered patients who were given prescription drugs without being warned about an increased risk of pancreatitis. Although many acute pancreatitis cases go away after about a week, it is common for the condition to return and serious injury and death can occur – especially with cases of hemorrhagic pancreatitis; liver, heart, or kidney impairment and necrotizing pancreatitis.

Januvia's link to pancreatitis

Januvia (sitagliptin), Merck & Company's Type 2 diabetes drug, has been linked to pancreatitis. Although there are many oral hypoglycemic drugs on the market, Januvia is unique in that it is an inhibitor called DPP-4 enzyme (dipeptidyl peptidase). Januvia was the first drug of this kind to hit the market; however, Januvia's side effects have been severe. In fact, according to the U.S. Food & Drug Administration's (FDA) Adverse Event Reporting System (AERS), nearly 90 cases of Januvia pancreatitis have been reported in the past four years. Of those cases:

• 21% of patients developed pancreatitis within 30 days of starting Januvia
• 53% of patients resolved their issues after they stopped taking Januvia
• 66% of patients had to hospitalized after taking Januvia
• 4 patients had to be admitted to an intensive care unit (ICU) after taking Januvia
• 2 patients experienced hemorrhagic or necrotizing pancreatitis

Januvia attorneys say that Merck rushed the product to market and that it knew about these risks, but failed to warn consumers, which has led to hundreds Januvia side effects and injuries and as a result – hundreds of Januvia lawsuits against the pharmaceutical giant.