Pancreatitis: symptoms, causes and treatment explained

Your pancreas is a soft gland that sits behind your stomach. It produces hormones to control your blood sugar levels and enzymes to help digest the fats in your food. Acute and chronic pancreatitis interferes with these functions and can, therefore, have a serious effect on your health and quality of life. 

Types of pancreatitis 

Acute pancreatitis

Acute pancreatitis is one of the most common causes of admission to hospital with acute abdominal pain and affects approximately 50 out of every 100,000 people in the UK. 

The most common cause of acute pancreatitis, accounting for over half of all cases, is gallstones. These can form in your gallbladder and escape into your bile duct, causing a temporary blockage of your pancreatic duct as they pass through. This can lead to inflammation in the pancreas gland, that is, acute pancreatitis. 

Another common cause of acute pancreatitis is drinking excessive amounts of alcohol — this accounts for around 30% of cases.

Chronic pancreatitis

Chronic pancreatitis is a long-term condition that results in the gradual, irreversible hardening of your pancreas, which is a soft tissue when healthy. 

It is most commonly caused by drinking excessive amounts of alcohol over a long period of time. Your risk of developing chronic pancreatitis is higher if you have previously had acute pancreatitis. In very rare cases, chronic pancreatitis is hereditary. Hereditary pancreatitis affects three to six individuals in every million. 

Pancreatitis symptoms

The most common symptom of acute pancreatitis is a sudden, severe pain in your upper abdomen, which may spread to your back. Other symptoms include nausea, loss of appetite, fever, jaundice (yellowing of your eyes) and feeling very unwell. 

In severe cases (around 10% of total cases), you may develop lung and kidney problems, which can lead to admission to intensive care and, in very rare cases (around one in every 100 cases), death. 

Other symptoms of chronic pancreatitis include unintentional weight loss, fatty stools that float and symptoms of diabetes ie feeling frequently thirsty and tired, and needing to urinate often.

Diagnosing pancreatitis

Acute pancreatitis is usually diagnosed through a blood test to check for elevated levels of the enzyme amylase, which is produced by your pancreas, and a CT scan to look for inflammation of your pancreas. 

Chronic pancreatitis usually relies on imaging tests, such as a CT scan, as there isn’t always an obvious spike in amylase levels due to the long-term nature of the disease. 

Treating pancreatitis

Acute pancreatitis

Left untreated, acute pancreatitis is life-threatening. What’s more, the vast majority of individuals with acute pancreatitis can make a full recovery with treatment. 

In the case of gallstone pancreatitis, the gallbladder is removed through surgery to prevent further attacks. If there is a stone in your bile duct an endoscopic procedure called endoscopic retrograde cholangiopancreatography (ERCP) may be needed first.

Acute pancreatitis in hospital is treated by giving fluids, nutritional support and oxygen. Over 80% of patients recover fully as long as the triggering factor is removed — namely, removing the gallbladder in the case of gallstone-induced pancreatitis and stopping drinking alcohol in alcohol-induced pancreatitis. 

Chronic pancreatitis

With chronic pancreatitis, although the damage caused can’t be reversed, the progression of the disease and importantly the symptoms can be stopped by quitting drinking alcohol. 

You will also need treatment to mitigate the damage caused to your pancreas and help you cope with your symptoms. This will usually involve being cared for by a multidisciplinary team including doctors specialising in chronic pancreatitis, pain management and diabetes, as well as dietitians.

Treatment often includes taking insulin if you have developed diabetes, pancreatic enzyme supplements and vitamin supplements. Vitamin supplements are needed as certain vitamins are absorbed via fats and chronic pancreatitis reduces your ability to absorb fats from your food. 

In rare cases of chronic pancreatitis, if you are in persistent, severe pain, your doctor may recommend surgery to remove your pancreas. Surgery to remove the pancreas is also recommended if you have hereditary pancreatitis as this type of pancreatitis increases your risk of pancreatic cancer by 50 times.