Patients with cases of pancreatitis for which doctors cannot determine a cause might have small gallstones to blame.
A recent study also showed the risk of developing pancreatitis, or inflammation of the pancreas, is higher during the first year of use of cholesterol-lowering drugs called statins.
The study from the University of Eastern Finland reported small gallstones were found in surgery from two out of three patients with seemingly causeless pancreatitis.
“This is an area we are learning more about now as patients present with pancreatitis of unknown cause,” Dr. Wolf said. “Taking out the gallbladder is what we typically recommend in these cases.”
Dr. Wolf said gallstones are a common cause of pancreatitis. Gallstones, produced in the gallbladder, can block the bile duct, forcing pancreatic enzymes back into the pancreas. The enzymes then begin to cause pancreatic inflammation.
Pancreatitis causes abdominal and back pain, as well as nausea, vomiting and inability to eat.
Many times gallstones are found on ultrasound and, when the patient’s gallbladder is removed, it cures the pancreatitis—unless there is another cause of the disease, Dr. Wolf said.
But what about patients for whom tests show no gallstones and yet symptoms persist without another known cause? This study affirms that patients should see a surgeon, like Dr. Wolf, who might opt to remove the gallbladder anyway.
“This study is beneficial because it gets the idea out there in the literature and will lead to further studies,” she said. “A lot of surgeons don’t recognize those issues when patients don’t have crystals that appear on ultrasound.”
Dr. Wolf pointed out that there are some potential side effects to gallbladder removal. Some patients will experience diarrhea for a few weeks or, in some cases, months as the digestive system adapts. There are also risks related to the operation itself, as with any surgery, she noted.
Doctors also can use diagnostic techniques, such as Endoscopic Retrograde Cholangiopancreatogram to visualize the bile and pancreatic ducts and, occasionally, test samples of the bile to determine if crystals are present.
The study, originally published in Pancreas, BMC Gastroenterology, Pharmacoepidemiology and Drug Safety, and Annals of Surgery, also showed that statin users are more susceptible to developing the condition.
Dr. Wolf said statins can change the composition of the bile, which can lead to crystal formation in the gallbladder and bile ducts. But she urged patients to continue statin use as directed by their physician. People should not hesitate using them if their doctor recommends them, she added.
“Statins are beneficial for various reasons,” Dr. Wolf said.