The pancreas is an organ that creates enzymes necessary to properly digest starch, protein, and fat. In addition, cells responsible for creating insulin are also found in the pancreas. Pancreatitis is a condition in which the pancreas is inflamed. When pancreatitis is prolonged, pancreatic function declines, leading to malabsorption of nutrients and, possibly, mild diabetes.
Pancreatitis occurs in three forms: acute (short-term) pancreatitis, recurrent acute pancreatitis, and chronic pancreatitis.
Acute pancreatitis is a painful condition, but with treatment it ordinarily resolves in 3 to 7 days. Causes include alcohol abuse, gallstones, extremely high blood levels of triglycerides, direct trauma to the pancreas, abdominal surgery and procedures, kidney failure, infection, and certain medications.
The treatment of acute pancreatitis consists primarily of resting the pancreas by discontinuing all eating and drinking. Intravenous fluids are used to maintain fluid balance.
Recurrent acute pancreatitis involves multiple bouts of acute pancreatitis, sometimes in the context of a more mild, chronic condition. Each bout is treated as described above.
Chronic pancreatitis is a more gradual process that leads to partial or complete pancreatic failure. Its most common cause is alcohol abuse, although the condition may also occur for other reasons, or for no known reason at all. Chronic pancreatitis causes many symptoms, including most prominently abdominal pain, weight loss, diarrhea because of undigested fat, and mild diabetes. Treatment primarily involves use of digestive enzymes and, if necessary, insulin, as well as dietary changes and pain medication. If alcohol abuse contributed to chronic pancreatitis, it’s important to stop drinking.
Digestive enzymes are the mainstay of treatment for chronic pancreatitis, and all of these can be considered natural products. The digestive enzymes prescribed by physicians for pancreatitis are not necessarily more powerful than their dietary supplement equivalent, and some experimentation with different products might lead to the best results. Excessive consumption of digestive enzymes can cause harm, however, and for this reason doctor’s supervision is strongly recommended.
Chronic pancreatitis leads to malabsorption of fat, which can in turn lead to deficiencies of fat-soluble vitamins, such as vitamin A and vitamin E.1,2 In addition, chronic pancreatitis might impair absorption of vitamin B12 and possibly other nutrients as well.1 While it is not clear that these deficiencies are severe enough to cause harm, it makes sense for people with pancreatitis to consider taking a multivitamin/mineral supplement as nutritional insurance.
Antioxidants are substances that help the body neutralize free radicals. Free radicals are dangerous, naturally occurring substances that are thought to play a role in pancreatitis, as well as many other conditions. A small double-blind, placebo-controlled trial of people with pancreatitis (chronic as well as recurring acute), examined the effectiveness of an antioxidant supplement providing 9,000 International Units (IU) beta-carotene, 540 milligrams (mg) vitamin C, 270 IU vitamin E, 600 micrograms (mcg) selenium, and 2,000 mg methionine daily.3 The results showed improvement both in symptoms and laboratory signs of disease severity. Similar results were found in a randomized trial among 127 men with chronic pancreatitis; 6 months of antioxidant treatment led to significant reduction in pain compared to placebo.6
In a detailed review of 4 studies, researchers concluded that the use probiotics did not benefit patients with severe acute pancreatitis.5 Furthermore, according to one study, the use of probiotics led to an increased risk of mortality in patients with severe acute pancreatitis, and should, therefore, be avoided.4 Similar results were found in a review of 6 randomized trials with 536 patients.7
A review of 19 randomized trials compared rhubarb and somatostatin to somatostatin alone in 1,161 patients with acute pancreatitis. The addition of rhubarb (given by gastric tube or retention enema) was associated with a reduced risk of complications, and shorter duration of abdominal pain, hospitalization, and time to first bowel movement. Rhubarb dosage ranged from 10-90 grams a day. Although the results were promising, all trials had biases that can affect the outcomes.8
Twersky Y, Bank S. Nutritional deficiencies in chronic pancreatitis. Gastroenterol Clin North Am. 1989;18:543–565.
Marotta F, Labadarios D, Frazer L, et al. Fat-soluble vitamin concentration in chronic alcohol-induced pancreatitis. Relationship with steatorrhea. Dig Dis Sci. 1994;39:993–998.
Uden S, Bilton D, Nathan L, et al. Antioxidant therapy for recurrent pancreatitis: placebo-controlled trial. Aliment Pharmacol Ther. 1990;4:357–371.
Besselink MG, van Santvoort HC, Buskens E, et al. Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial. Lancet. 2008 Feb 13.
Sun S, Yang K, He X, et al. Probiotics in patients with severe acute pancreatitis: a meta-analysis. Langenbecks Arch Surg. 2008 Jul 17.
Bhardwaj P, Garg PK, Maulik SK, et al. A randomized controlled trial of antioxidant supplementation for pain relief in patients with chronic pancreatitis. Gastroenterology. 2008 Sep 25.
Gou S, Yang Z, et al. Use of probiotics in the treatment of severe acute pancreatitis: a systematic review and meta-analysis of randomized controlled trials.Crit Care. 2014;18(2):R57.
Zhou Y, Wang L, Huang X, Li H, Xiong Y. Add-on effect of crude rhubarb to somatostatin for acute pancreatitis: A meta-analysis of randomized controlled trials. J Ethnopharmacol. 201624;194:495-505.
Last reviewed December 2015 by EBSCO CAM Review Board
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.