Inflammation of the Pancreas: Medical History

Medical history (history of illness) is an important component in the diagnosis of pancreatitis (inflammation of the pancreas). Family history

• Are there any diseases of the digestive system in your family that are common?

Social history

• Is there any evidence of psychosocial stress or strain due to your family situation?

Current medical history/systemic history (somatic and psychological complaints).

• How long has the abdominal pain been present? Has the pain changed? Become more severe?
• Did the pain come on suddenly? *
• Where exactly is the pain localized? Does the pain radiate?
• What is the character of the pain? Stabbing, dull, burning, tearing, colicky, etc.?
• When does the pain occur? Are you dependent on external factors such as diet, stress, weather?
• Is the pain dependent on breathing? *
• Does the pain intensify or get better with exertion/movement?
• Do other symptoms (e.g., nausea, vomiting, diarrhea, constipation, bloating, difficulty swallowing, heartburn, etc.) occur in addition to abdominal pain?
• Have there been any changes in bowel movements and/or urination? In quantity, consistency, admixtures? Does it come to pain in the process?
• Have you had any recent injuries?
• Have you lost any body weight?
• Do you have a fever?
• Have you noticed a yellowish discoloration of the skin?
• Do you have any gynecological abnormalities (e.g., dysmenorrhea/regular pain; missed period)?
• Do you have nocturnal pain that wakes you up?
• Have you had an infectious disease recently?

Vegetative anamnesis including nutritional anamnesis.

• Are you overweight? Please tell us your body weight (in kg) and height (in cm).
• Has your appetite changed?
• Do you smoke? If so, how many cigarettes, cigars, or pipes per day?
• Do you drink alcohol? If yes, what drink(s) and how many glasses per day?
• Do you use drugs? If yes, what drugs and how often per day or per week?

Self history incl. medication history.

• Pre-existing conditions (gastrointestinal diseases, infectious diseases).
• Operations (abdominal surgery)
• Allergies

Medication history

The following is a list of medications that can lead to pancreatitis [very rare! : 0.05% of cases] (No claim to completeness! ):

• ACE inhibitors* (captopril* * , enalapril* , simvastatin/1 case).
• Non-steroidal anti-inflammatory drugs (acetylsalicylic acid* (ASA), ibuprofen* , paracetamol).
• Antibiotics
  • Sulfonamides (sulfamethoxazole)
  • Metronidazole
  • Nitrofurantoin*
  • Tetracyclines (doxycycline*
  • Trimethoprim
• Antiepileptic drugs (carbamazepine, valproate).
• Antihypertensia (methyldopa)
• Antifungals (fluconazole)
• Anti-inflammatory drugs (oxphenbutazone, 5-aminosalicylic acid preparations* ).
• Antiprotozoal agents (pentamidine).
• Biguanides (phenformin
• Biphosphates (alendronic acid* * )
• Calcium antagonists (felodipine)
• Intestinal therapeutics (anti-inflammatories) – olsalcin (composed of two molecules of the substance mesalazine), mesalazine (also 5-aminosalicylic acid (5-ASA))* .
• Dipeptidyl peptidase 4 inhibitors (DPP-4 inhibitors; gliptins) (saxagliptin, sitagliptin, vildagliptin).
• Diuretics
  • Loop diuretics (furosemide)
  • Thiazide diuretics
• H2 antihistamines (cimetidine, famotidine* )Immunotherapeutics (interferon α).
• Hormones
  • Glucocorticoids (cortisone, methylprednisolone).
  • Methandrostenolone (anabolic steroid).
  • Estrogens* (especially hormone replacement therapy menopausal women).
• Immunosuppressants (azathioprine).
• Combination vaccination against measles and mumps (1 case).
• Lipid-lowering drug
  • Fibrates (ciprofibrate* * ; fenofibrate)
• Narcotic (propofol)
• Thiamazole and carbimazole (thyrostatic drugs) (+56%) Note: For propyluracil, there is no increased risk according to the data of the present study)Note: The European Medicines Agency (EMA) has recommended adding a potential side effect to the package inserts and SmPCs of the thyrostatic drugs carbimazole and thiamazole (active metabolite of carbimazole): acute pancreatitis. I.e. also that for patients with a history of acute pancreatitis, the corresponding preparations are contraindicated.
• Antivirals
  • Nucleoside reverse transcriptase inhibitors (didanosine/dideoxyinosine, lamivudine, stavudine).
  • Fusion inhibitors (enfuvirtide).
• Cytostatic agents (asparaginase, blinatumomab, cytarabine, 6-mercaptopurine).

* Relationship probable * * Possible causal relationship.

Environmental history

• Organophosphates (e.g., E605)

* If this question has been answered with “Yes”, an immediate visit to the doctor is required! (Information without guarantee)