Pancreatitis is when the pancreas, a long flat organ behind your stomach, becomes inflamed. It causes belly pain, vomiting, and can sometimes be life-threatening. In the U.S., around 50,000 people are hospitalized for it each year.
Most people experience a mild, temporary form that goes away, but some face severe or recurring issues. The symptoms and treatment depend on whether it’s acute or chronic.
Acute pancreatitis starts suddenly and usually doesn’t recur. It causes unexpected upper abdominal pain that typically resolves quickly with treatment. Severe acute pancreatitis occurs in about 10% of cases. On the other hand, chronic pancreatitis involves ongoing inflammation, scarring, and damage, often following repeated acute episodes, but can also develop without prior symptoms.
Acute cases are typically managed by general healthcare providers, while chronic pancreatitis requires a gastroenterologist, a specialist in digestive diseases. The key symptom is abdominal pain, often in the upper area and radiating to the back. Acute cases might present severe but brief pain, while chronic cases involve persistent, less intense pain. Nausea and vomiting are common in acute cases, which may also feature high heart rates or fever. Severe pancreatitis can lead to serious issues like kidney failure or pancreatic necrosis, which can result in sepsis, a dangerous response to infection.
The pancreas releases hormones like insulin and digestive enzymes into the small intestine. In severe chronic cases, the damage impairs this function, leading to symptoms like greasy stools, diarrhea, and a form of diabetes known as type 3c diabetes. Acute inflammation is sudden and usually reversible, whereas chronic inflammation is persistent but often less severe.
Gallstones are the leading cause of pancreatitis worldwide. These small, hard deposits can block the ducts from the pancreas, causing self-damage. Alcohol is another major cause of acute pancreatitis, along with high levels of certain fats in the blood. Smoking and heavy drinking are major risk factors, and genetics also play a role. Several medical conditions with different treatments can similarly cause sudden abdominal pain, so it’s vital for healthcare providers to rule out other causes to diagnose pancreatitis correctly. Diagnosis often involves a medical history, physical exam, additional lab tests, and possibly imaging to examine the pancreas.
Treatment varies by whether the pancreatitis is acute or chronic and includes managing complications. Acute treatment focuses on pain relief and preventing severe complications. Some may require intensive care, like breathing assistance or kidney support, and procedures to address underlying causes like gallstones might be necessary.
Chronic pancreatitis treatment emphasizes pain management, potentially with smaller, more frequent meals to ease discomfort, and addressing pancreatic function loss, which might include medication for enzyme replacement. Diabetes from pancreatitis is managed by controlling blood sugar levels.
Lifestyle changes can help prevent pancreatitis, such as drinking in moderation or abstaining from alcohol and quitting smoking, which reduces risk. Reducing gallstone risk is also crucial, especially if they’ve already caused pancreatitis, and gradual weight loss is advised to prevent gallstones.
In some cases, gallstone-related pancreatitis might be addressed by surgically removing the gallbladder. Chronic pancreatitis or severe acute cases can lead to type 3c diabetes because the pancreas can’t produce enough insulin, potentially raising glucose levels dangerously. Estimates suggest 15% of acute pancreatitis cases and up to 40% of chronic cases lead to diabetes. Chronic pancreatitis also increases the risk of pancreatic cancer and osteoporosis.
After an initial pancreatitis attack, 20% may experience additional episodes, and half of those might develop chronic pancreatitis. This is more likely among those who continue heavy drinking or smoking. Living with chronic pain can be challenging, and finding a supportive network or therapist may help in coping.
