Pancreatitis

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is pancreatitis?

Pancreatitis is an inflammation of the pancreas. The pancreas is a gland behind the stomach that plays a key part in the digestive process. It secretes digestive juices into the small intestine, and these juices break down food. The pancreas also releases insulin and glucagon, two hormones that help the body regulate glucose levels.

The pancreas can become inflamed if the digestive juices, called enzymes, attack the gland itself, causing damage to the tissues of the pancreas. Pancreatitis can be an acute or a chronic condition.

Common pancreatitis causes include gallstones that form in the nearby gallbladder and travel to the pancreas via the common bile duct; long-term, heavy alcohol use; and certain conditions such as cystic fibrosis.

Acute pancreatitis may start as a minor pain in the abdomen spreading to the back. The pain may intensify and worsen. Seek immediate medical care (call 911) for serious symptoms, such as a swollen and tender abdomen, fever, nausea, rapid pulse, and vomiting.

Seek prompt medical care if you are being treated for chronic pancreatitis, but you have mild symptoms that persist, recur, or cause you concern.

What are the different types of pancreatitis?

Acute pancreatitis often starts as severe pain in the upper abdomen that may spread to the back. Most cases are mild and only last a few days. With proper treatment, acute pancreatitis usually resolves, although the condition and its complications may be life-threatening in some cases. There are about 200,000 hospitalizations in the United States each year due to acute pancreatitis.

Chronic pancreatitis is a long-term condition that can result in permanent damage. In this condition, the pancreas is slowly destroyed until it can no longer produce the important digestive enzymes. This process usually takes years. It can occur after repeated bouts of acute pancreatitis. Treatment may include a prescription for synthetic pancreatic enzymes.

What are the symptoms of pancreatitis?

Acute and chronic pancreatitis often present with the same symptoms. Symptoms of chronic pancreatitis are ongoing or recurring and may require permanent dietary and lifestyle changes. Symptoms of pancreatitis affect the pancreas and other organs in the digestive system.

Common symptoms of pancreatitis

You may experience pancreatitis symptoms daily or just once in a while. At times, any of these pancreatitis symptoms can be severe:

  • Abdominal pain or cramping

  • Abdominal swelling, distension or bloating

  • Fever

  • Low blood pressure

  • Nausea with or without vomiting

  • Rapid heart rate (tachycardia)

  • Severe abdominal, pelvic, or lower back pain

  • Yellowing of the skin and whites of the eyes (jaundice)

Serious symptoms that might indicate a life-threatening condition

In some cases, acute pancreatitis can be life-threatening. Seek immediate medical care (call 911) for any of these life-threatening symptoms including:

What causes pancreatitis?

Pancreatitis is an inflammation of the pancreas. The pancreas can become inflamed if the digestive juices it produces, called enzymes, attack the gland itself. Pancreatitis can be an acute or a chronic condition.

Common causes of pancreatitis

Causes of pancreatitis include:

  • Abdominal injury or trauma

  • Adverse effects of certain drugs, such as steroids

  • Alcohol abuse

  • Complications of medical procedures, such as imaging studies of the bile ducts

  • Cystic fibrosis (hereditary disease characterized by buildup of abnormally thick, sticky mucus in the lungs and other organs)

  • Drug allergy, such as allergy to penicillin or codeine

  • Gallstones, which cause 40% of acute pancreatitis cases

  • Hypercalcemia (high level of calcium in the bloodstream)

  • Hyperlipidemia (high level of fats in the bloodstream)

  • Infections (such as mumps, coxsackie, cryptosporidiosis)

  • Pancreatic cancer

What are the risk factors for pancreatitis?

Several factors increase the risk of developing pancreatitis. Not all people with risk factors will get pancreatitis. Risk factors for pancreatitis include:

  • African American race

  • Cigarette smoking

  • Excessive alcohol use

  • Family history of pancreatitis or a personal or family history of gallstones

  • Male sex

  • Obesity, high triglycerides, or diabetes

How do you prevent pancreatitis?

Preventing disease relies on changing risk factors that are under your control. You may be able to prevent or reduce your risk of pancreatitis by:

  • Controlling diabetes and high triglycerides

  • Eating a low-fat, healthy diet and drinking extra fluids

  • Getting regular physical exercise

  • Limiting alcohol consumption

  • Maintaining a healthy body weight

  • Stopping smoking

These lifestyle habits will also help prevent gallstones, which are a major cause of acute pancreatitis.

What are the diet and nutrition tips for pancreatitis?

When you have pancreatitis, there are dietary changes you can make to aid your recovery. These same changes can also help you avoid bouts of acute pancreatitis in the future. Diet and nutrition tips for pancreatitis include:

  • Do not consume alcohol.

  • Drink plenty of fluids to avoid dehydration. Water is best, but you can choose other liquids. Just avoid caffeinated beverages.

  • Eat a low-fat diet that includes lots of whole grains, lean proteins, and fresh fruits and vegetables. 

  • Have smaller, more frequent meals throughout the day instead of three large ones.

Ask your healthcare professional for guidance before making significant changes to your diet.

What are some conditions related to pancreatitis?

Gallstones are an important condition related to pancreatitis. They are the most common cause of acute pancreatitis, accounting for 40% of cases.

Gallstones occur when hard deposits of cholesterol or bilirubin form in the gallbladder. Most of the time, gallstones do not cause symptoms. However, when they move into the bile ducts, symptoms can develop.

The bile ducts carry stored bile from the gallbladder into the intestine to digest food. The bile ducts also carry enzymes from the pancreas into the intestine. When gallstones block the bile ducts, it causes inflammation in the pancreas.

Symptoms of a gallstone blockage are similar to pancreatitis. They include radiating abdominal pain, nausea and vomiting. Since there is a 70% chance of recurrence, most doctors recommend surgery to remove the gallbladder.

The risk factors for gallstones are also similar. This includes being obese, having high triglycerides or diabetes, and eating a diet high in fat and calories. The preventive steps you can take to reduce the risk of pancreatitis will also help you avoid gallstones.

How do doctors diagnose pancreatitis?

To diagnose pancreatitis, your doctor will take a medical history, perform an exam, and order testing. Questions your doctor may ask include:

  • What symptoms are you experiencing?

  • When did your symptoms start?

  • Are your symptoms continuous or do they come and go?

  • What, if anything, seems to make your symptoms better or worse?

  • Have you ever had pancreatitis or gallstones before?

  • Do you have a family history of pancreatitis or gallstones?

  • How much alcohol do you drink?

  • Do you smoke?

  • What other medical conditions do you have?

  • What medications do you take?

During the exam, your doctor will feel your abdomen, checking for pain, swelling or tenderness.

Tests for pancreatitis

To confirm a diagnosis of pancreatitis, your doctor will order testing. For acute pancreatitis, this may include:

  • Blood tests to check levels of the pancreatic enzymes amylase and lipase

  • Imaging exams, such as ultrasound or CT (computed tomography), to look for gallstones and inflammation of the pancreas

If your doctor suspects chronic pancreatitis, more involved testing is usually necessary. This may include:

  • Endoscopic ultrasound, an internal imaging exam that involves passing a small device through the mouth into the stomach and small intestine. It gives a clearer image of the gallbladder and pancreas.

  • ERCP (endoscopic retrograde cholangiopancreatography), another internal imaging exam that uses a dye to examine the pancreas and bile ducts

  • Secretin pancreatic function test, which checks how well the pancreas responds to the hormone secretin

  • Stool tests to measure the amount of fat in your stool

How do you treat pancreatitis?

If you have acute pancreatitis, you will need treatment in the hospital. Pancreatitis treatment includes antibiotics, IV (intravenous) fluids, and medication to relieve pain. You will likely not have food or fluids by mouth during this hospital stay to allow your digestive system to rest.

If you are vomiting, your doctor may place a tube through your nose and into your stomach to remove air and fluid. Your doctor will advise you not to drink alcohol, consume fatty or greasy foods, or smoke while your pancreas heals.

Severe acute pancreatitis or chronic pancreatitis may require more intensive treatment. Your doctor also may prescribe a synthetic pancreatic enzyme along with a low-fat diet.

Procedures to treat pancreatitis

In some cases, surgical or invasive procedures may be required for pancreatitis. These include:

  • Bile duct drainage or removal of an obstruction with an endoscopic retrograde cholangiopancreatography (ERCP), in which a long, flexible tube with a camera is guided through the digestive system to the area of blockage

  • Surgical removal of the gallbladder (cholecystectomy), if gallstones are the cause of the pancreatitis

  • Surgical removal of the pancreas (pancreatectomy), either complete or partial

What are the potential complications of pancreatitis?

Complications of untreated or poorly controlled pancreatitis can be serious and even life-threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan that you and your healthcare professional design specifically for you. Complications of pancreatitis include:

  • Adverse effects of treatment for pancreatitis

  • Development of diabetes (chronic disease that affects your body’s ability to use sugar for energy)

  • Malnutrition

  • Pancreatic cancer

  • Pseudocyst (development of fluid collections in the pancreas that may cause bleeding or infection)

  • Severe discomfort or pain

  • Spread of cancer

  • Spread of infection

  • Surgical removal of the pancreas
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Oct 7
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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