Overview
Pancreatitis means inflammation of the pancreas. The pancreas lies in the upper tummy. It makes juices that help digest food, and hormones such as , which controls blood sugar.
In acute pancreatitis the swelling starts suddenly and needs urgent hospital treatment. Most people recover fully, but it can be life-threatening, and attacks can come back. In chronic pancreatitis the pancreas becomes scarred over time and the damage is permanent.
Symptoms
The main symptom of acute pancreatitis is pain in the upper tummy. The pain:
- Often starts suddenly and is severe and constant
- May spread to the back or sides
- Gets worse after eating or lying flat, and eases when leaning forward
Other symptoms include nausea, vomiting, a high temperature, a fast pulse and a tender, bloated tummy. Chronic pancreatitis causes pain that comes and goes or is constant, with weight loss, bloating, and pale, oily, foul-smelling stools. Great thirst and passing a lot of urine can signal diabetes.
When to see a doctor
See a doctor soon for repeated bouts of upper tummy pain, especially after meals or alcohol, or for weight loss without trying, pale oily stools, great thirst with a lot of urine, or gallstones that keep causing pain.
Causes
The two most common causes are:
- Gallstones, which can block the pancreatic duct, a common cause of acute pancreatitis
- Heavy, long-term alcohol use, the most common cause of chronic pancreatitis
Less common causes include injury, some medicines, high calcium or fats in the blood, infections such as mumps, autoimmune disease, inherited conditions such as cystic fibrosis, and rarely a tumour. Sometimes no cause is found.
Risk factors
- Having gallstones
- Drinking a lot of alcohol
- Smoking
- A family history of pancreatitis
- High calcium or fat levels in the blood
- Taking some medicines
- Having had pancreatitis before
Complications
Most people recover well, but pancreatitis can cause serious problems:
- Fluid-filled cysts in the pancreas, which can become infected
- Death of pancreatic tissue (necrosis), which may need surgery and
- Chronic pancreatitis, after repeated attacks
- Poor digestion, weight loss and weak bones
- Diabetes, if the pancreas can no longer make enough
- A higher risk of pancreatic cancer in chronic pancreatitis
Prevention
Having pancreatitis once means it can happen again, so lowering the risk matters:
- Drink less alcohol or none at all, and stop completely if you have chronic pancreatitis
- Stop smoking
- Eat a healthy diet that is low in fat
- Have gallstones treated if a doctor advises it
- Ask a doctor whether a medicine you take could be a cause
Diagnosis
A doctor asks about the pain, alcohol use, gallstones, medicines and family history, and examines your tummy. Tests may include:
- Blood tests, including amylase and lipase
- An or of the tummy
- Endoscopic ultrasound or ERCP, camera tests through the mouth to see the pancreas and bile ducts
- Stool tests, in chronic pancreatitis, to check digestion
Treatment
Acute pancreatitis is treated in hospital with fluids and nutrition through a drip, pain relief and, if infection develops, . Most people begin to improve within about a week, though a severe attack needs a longer stay.
The cause is treated too: gallstones may need surgery, alcohol must be stopped with support if needed, and a medicine that caused it is changed. A low-fat diet is often advised.
Chronic pancreatitis cannot be cured, but treatment relieves symptoms: pain relief, digestive enzyme tablets, or other medicines for diabetes, a healthy diet, and stopping alcohol and smoking. Surgery sometimes clears blocked ducts or cysts.
Myths and facts
Things people often say about this. Open each one to see what is true.
Myth“Severe tummy pain is just gas or acidity, and an antacid will settle it.”What is true?
Fact
Pancreatitis can feel like acidity or an ulcer, and also like appendicitis. Sudden, severe tummy pain that does not go away, spreads to the back or comes with vomiting needs urgent medical assessment, not home treatment.
Myth“Pancreatitis only happens to people who drink a lot.”What is true?
Fact
Heavy drinking is one of the two most common causes, along with gallstones, which affect people who do not drink at all. Some medicines, an injury, high calcium or fat levels in the blood, infections such as mumps, and inherited conditions can also cause it.
Myth“Once the pain has settled, no further care is needed.”What is true?
Fact
Pancreatitis can happen again if the cause is not dealt with. Gallstones may need treatment, and drinking less alcohol or none, stopping smoking and eating a low-fat diet lower the risk. Repeated attacks can lead to long-term damage.
Myth“A drink now and then does no harm after pancreatitis.”What is true?
Fact
Doctors advise people with chronic pancreatitis to stop alcohol completely, even when alcohol was not the cause, because it can cause further damage. After a sudden attack, drinking less or none lowers the risk of another.
Questions to ask your doctor
Tick the ones you want answered and take them with you.
Common questions
Is pancreatitis curable?
Most people with a sudden attack recover fully once it is treated, especially when the cause is dealt with. Chronic pancreatitis cannot be cured, but pain relief, digestive enzyme tablets, a healthy diet and stopping alcohol and smoking can ease symptoms and slow the damage.
How long will I stay in hospital?
It varies. Many people with a sudden attack begin to improve within a week and go home after about five to ten days. A severe attack, or one with complications, can mean a longer stay.
Can pancreatitis come back?
Yes. Having it once means it can happen again. Treating the cause, such as gallstones, drinking less alcohol or none, stopping smoking and eating a healthy low-fat diet all lower the chance.
What can I eat after pancreatitis?
A doctor may advise a low-fat diet and no alcohol. A dietitian can help plan meals that give you the nutrition you need. Follow the advice your own doctor gives, because it depends on the type of pancreatitis and how you are recovering.
