Pancreatitis

Overview

Pancreatitis is inflammation of the pancreas, a gland located behind the stomach that produces enzymes to digest food and hormones such as insulin that control blood sugar. Normally these digestive enzymes become active only after they reach the intestine. In pancreatitis they become active too early, inside the pancreas itself, and begin to irritate and damage the organ.

There are two main forms. Acute pancreatitis comes on suddenly, often with severe abdominal pain, and usually settles within days with treatment, though it can occasionally be serious or life-threatening. Chronic pancreatitis is long-lasting inflammation that gradually damages the pancreas over years, affecting digestion and sometimes blood sugar control. The two most common causes are gallstones and heavy alcohol use.

Symptoms

The main symptom is pain in the upper abdomen, though it varies between the acute and chronic forms.

• Upper abdominal pain that may spread to the back
• Pain that can be sudden and severe (acute) or persistent and recurring (chronic)
• Pain that often worsens after eating, especially fatty meals
• Nausea and vomiting
• Fever and a rapid pulse in acute attacks
• Weight loss, greasy or foul-smelling stools, and digestive problems in the chronic form

Severe, constant abdominal pain, especially with vomiting, fever, or feeling very unwell, needs urgent medical assessment.

Causes

Pancreatitis develops when digestive enzymes are activated inside the pancreas and damage it. The leading causes are:

• Gallstones: A stone can block the duct shared by the gallbladder and pancreas, backing up enzymes and triggering inflammation.
• Heavy alcohol use: A major cause of both acute attacks and chronic pancreatitis.

Less common causes include very high blood fat (triglyceride) levels, certain medications, high blood calcium, abdominal injury, some infections, and inherited conditions. In some cases no cause is found. Smoking increases the risk and can worsen the disease.

Risk Factors

• Gallstones
• Heavy or long-term alcohol use
• Smoking
• Very high triglyceride levels
• A family history of pancreatitis
• Obesity and diabetes
• Certain medications and high blood calcium

Diagnosis

Doctors diagnose pancreatitis using symptoms, blood tests, and imaging:

• Blood tests: Raised levels of pancreatic enzymes (amylase and lipase) support the diagnosis, and other tests assess severity and causes.
• Ultrasound: Often used to look for gallstones.
• CT or MRI scans: Provide detailed views of the pancreas to assess inflammation and complications.
• Specialized tests: In chronic cases, additional imaging and tests of digestion may be used.

Treatment

Treatment depends on whether the pancreatitis is acute or chronic and how severe it is.

• Hospital care for acute attacks: Most people need fluids through a vein, pain relief, and rest for the pancreas, with eating reintroduced as the attack settles.
• Treating the cause: Removing the gallbladder for gallstone pancreatitis, stopping alcohol, lowering triglycerides, or adjusting medications.
• Managing chronic disease: Pain control, enzyme supplements to aid digestion, and treatment of diabetes if it develops.
• Procedures or surgery: Sometimes needed to clear blocked ducts, drain fluid collections, or manage complications.

Avoiding alcohol and not smoking are central to preventing recurrence and slowing damage.

Prevention

• Limit or avoid alcohol
• Do not smoke
• Maintain a healthy weight and balanced diet
• Have gallstones treated if they cause symptoms
• Keep triggers such as high triglycerides and diabetes well managed
• Take only the medications you need and review them with your doctor

When to See a Doctor

Seek prompt medical care for severe or persistent upper abdominal pain, especially if it spreads to the back or comes with vomiting. Go to an emergency department or call emergency services if you have:

• Sudden, severe, constant abdominal pain
• Pain with fever, a rapid heartbeat, or feeling very unwell
• Persistent vomiting and inability to keep fluids down
• Yellowing of the skin or eyes, or signs of shock such as faintness

Severe acute pancreatitis can be life-threatening and needs immediate treatment.

Related Topics

Frequently Asked Questions

References

1. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Pancreatitis.
2. Mayo Clinic. Pancreatitis — Symptoms and causes.
3. MedlinePlus, U.S. National Library of Medicine. Pancreatitis.
4. American College of Gastroenterology. Acute Pancreatitis.