Pancreatitis
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is pancreatitis?
Pancreatitis is inflammation of the pancreas, most often caused by gallstones or alcohol. Acute pancreatitis causes severe upper abdominal pain radiating to the back and can range from mild to life threatening. Chronic pancreatitis causes permanent damage with pain, malabsorption and diabetes.
Causes
- Gallstones obstructing the pancreatic duct
- Excess alcohol intake
- Very high blood triglycerides
- Certain medicines
- Abdominal trauma or ERCP procedures
- High blood calcium
- Genetic mutations and autoimmune pancreatitis
Symptoms
- Severe upper abdominal pain radiating to the back
- Pain often eased by leaning forward
- Nausea and vomiting
- Abdominal tenderness and distension
- Fever and rapid pulse
- Jaundice if the bile duct is obstructed
- Greasy floating stools in chronic disease
- Weight loss and diabetes in chronic disease
Risk factors
- Gallstone disease
- Heavy alcohol consumption
- Smoking, particularly for chronic pancreatitis
- Obesity
- High triglycerides
- Family history of pancreatitis
Diagnosis
- Serum lipase or amylase raised threefold above normal
- Abdominal ultrasound to look for gallstones
- CT scan to assess severity and complications
- MRCP or endoscopic ultrasound for duct assessment
- Triglyceride and calcium measurement
- Severity scoring to guide level of care
Treatment
- Aggressive intravenous fluid resuscitation
- Effective analgesia
- Early enteral feeding rather than prolonged fasting
- Treating the cause, including cholecystectomy for gallstones
- ERCP for obstructing bile duct stones with cholangitis
- Complete alcohol and smoking cessation
- Pancreatic enzyme replacement in chronic disease
- Intensive care for severe or necrotising pancreatitis
Self care
- Stop alcohol completely and permanently
- Stop smoking, which accelerates chronic damage
- Eat smaller low fat meals during recovery
- Take pancreatic enzyme supplements with meals if prescribed
- Stay well hydrated
- Attend follow up for gallstone treatment if that was the cause
- Monitor for diabetes symptoms in chronic disease
When to see a doctor
Book an appointment if:
- Recurrent episodes of upper abdominal pain
- Greasy floating stools or weight loss
- New diabetes symptoms after pancreatitis
- Ongoing pain between attacks
- Difficulty maintaining weight
- To arrange gallbladder surgery after a gallstone attack
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Avoid excess alcohol, the leading preventable cause
- Have gallstones treated after a first attack
- Manage very high triglycerides
- Stop smoking
- Review medicines known to cause pancreatitis
- Maintain a healthy weight
Outlook
Around 80 percent of acute attacks are mild and resolve within a week with supportive care. Severe necrotising pancreatitis carries significant mortality and needs intensive care. Recurrent attacks can progress to chronic pancreatitis with permanent pain, malabsorption and diabetes, which is why removing the cause after a first episode matters so much.
Common questions
Why is treating the cause so important?
Without removing the gallbladder or stopping alcohol, pancreatitis frequently recurs, and repeated attacks can progress to chronic pancreatitis with permanent damage, chronic pain and diabetes.
Is fasting still recommended?
No. Current evidence supports early oral or enteral feeding as tolerated, which is associated with fewer infectious complications and shorter hospital stay compared with prolonged bowel rest.
What are the danger signs?
Persistent organ dysfunction beyond 48 hours, breathing difficulty, low blood pressure, reduced urine output or confusion indicate severe disease requiring intensive care, which carries significant mortality.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.