Pancreatitis
Your health expert: Mr Christian Macutkiewicz, Consultant General & Hepato-Pancreatico-Biliary Surgeon
Content editor review by Pippa Coulter, Freelance Health Editor, June 2023
Next review due June 2026
Pancreatitis is when your pancreas becomes inflamed, which can stop it working properly. It can happen suddenly (acute pancreatitis) or because of long-term damage (chronic pancreatitis). It’s often related to gallstones or drinking too much alcohol.
About pancreatitis
Your pancreas is an organ in your digestive system. It’s about 12–15cm long and sits just behind your stomach. Your pancreas makes enzymes which help to break down the foods you eat. It also makes insulin, which helps to control the level of glucose (sugar) in your blood.
In pancreatitis, your pancreas becomes inflamed. This causes symptoms such as pain. If it’s severe or lasts for a long time, it can also damage your pancreas and stop it working properly. Pancreatitis can be classed as acute or chronic.
- Acute pancreatitis usually comes on suddenly and lasts for a short time. Most people have a mild illness and will make a full recovery within a few days. But some people are more severely affected. Acute pancreatitis is usually a one-off illness, but sometimes it can come back, unless the cause is found and treated.
- Chronic pancreatitis is when your pancreas is constantly inflamed over a long period of time. This causes ongoing damage and scarring which affects how well your pancreas works. Chronic pancreatitis is a long-term condition that you’ll normally have for life.
Acute pancreatitis is more common than chronic pancreatitis. But both types are becoming more frequent in the UK. Men are more likely to develop chronic pancreatitis than women.
Causes of pancreatitis
The main causes of pancreatitis are the following.
- Gallstones (hard lumps that develop in your gallbladder). These cause around half of all cases of acute pancreatitis.
- Regularly drinking a lot of alcohol. This causes around a quarter of cases of acute pancreatitis. It’s also the most common cause of chronic pancreatitis.
Certain other things can also increase your risk of developing pancreatitis. These include the following.
It’s not always possible to find a reason why someone has developed pancreatitis.
Symptoms of pancreatitis
The main symptom for both acute and chronic pancreatitis is severe pain in your upper abdomen (tummy). It’s usually in the middle or top left of your abdomen, and can spread to your back. The pain can get worse when you move, and feel better if you lean forward or curl into a ball. Sometimes it’s worse after eating.
Acute pancreatitis
With acute pancreatitis, the pain comes on suddenly over a few hours then becomes constant. Some people say it feels like being stabbed with a knife.
Other acute pancreatitis symptoms include:
- feeling and being sick
- losing your appetite
- a fast heartbeat
- fever
- your abdomen feeling tender or swollen
Chronic pancreatitis
In chronic pancreatitis, you tend to get a dull, deep pain. It can be constant or it may come and go. Around 1 in 5 people with chronic pancreatitis don’t get any pain at all.
Chronic pancreatitis is ongoing, which means it can start to affect your body in other ways too. Other chronic pancreatitis symptoms include:
- feeling and being sick
- having pale, runny poo that smells bad and is difficult to flush away – this is known as steatorrhoea
- feeling bloated, getting tummy cramps and passing wind (farting) more often than usual
- losing weight
- developing yellow-coloured skin and a yellow tinge to the whites of your eyes (jaundice)
Contact your GP or call 111 for medical advice straight away if you develop severe pain in your abdomen.
Diagnosis of pancreatitis
Your doctor will ask about your symptoms and your medical and family history. They’ll want to know how much alcohol you drink. Your doctor will examine you and carry out some basic tests such as checking your pulse rate and blood pressure.
If your GP thinks you might have acute pancreatitis, you should be admitted to hospital straight away. You will have tests there to confirm a diagnosis. If your symptoms are thought to be due to chronic pancreatitis, your GP may arrange some tests or may refer you to a specialist doctor. As well as confirming a diagnosis, tests for pancreatitis can help identify a cause. This will help with treatment.
You may have some of the following tests.
- Blood tests to check for pancreatic enzymes or diabetes.
- An X-ray of your chest or abdomen (tummy). This can help identify a cause or rule out other problems.
- Imaging scans of your abdomen with ultrasound , CT or MRI .
- More specialist imaging tests if needed. These include magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasonography (EUS). These tests can provide clearer images of your pancreas.
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Pancreatitis treatment
Acute pancreatitis
If you have acute pancreatitis, you’ll usually need to be admitted to hospital for treatment. Treatment for acute pancreatitis aims to manage any complications or reduce the risk of them developing. Your doctor may be able to treat the underlying cause of your pancreatitis. You’ll also have treatment to manage your pain and any other symptoms such as sickness.
Hospital treatment
The main treatments you’re likely to have for acute pancreatitis include:
- intravenous fluids given through a drip into a vein in your arm
- oxygen through a facemask
- painkillers – these may include medicines called opiates (for example, morphine) if your pain is severe
- medicines to treat any sickness
- antibiotics if you have any signs of infections
You will be encouraged to start eating as soon as you can. This is important because it can protect your gut and reduce the risk of complications. If you’re unable to eat straight away, you will be given a feeding tube.
Most people find that their symptoms get much better within a week of starting treatment and are then able to go home. But if your pancreatitis is severe or you develop complications, you may need to stay in hospital for much longer – even several months.
Gallstones
If your pancreatitis is caused by gallstones, you’ll need treatment to remove them. This can be done with surgery to remove your gallbladder (a cholecystectomy). If a gallstone is stuck in your bile duct, this can be removed with a procedure called an endoscopic retrograde cholangiopancreatography (ERCP). If you have severe pancreatitis, doctors will usually wait at least 6 weeks for your symptoms to improve before doing surgery.
Chronic pancreatitis
If you have chronic pancreatitis, you will need ongoing treatment and care. Chronic pancreatitis treatment is aimed at managing your symptoms and any complications.
Your care is likely to be managed by a specialist team of health professionals. These may include a gastroenterologist, a dietician and a pain specialist. This care may be through a specialist pancreatitis centre. Your GP will also be involved in your care. You may get flare-ups or attacks of acute pancreatitis, where your symptoms suddenly get worse. This will need treatment in a hospital – see our section on acute pancreatitis above.
Lifestyle changes
If you smoke or drink alcohol, your doctor will recommend that you stop. This may help reduce the risk of complications and attacks of acute pancreatitis. Your doctor can advise you on local stop-smoking services or specialist alcohol services.
Diet and nutrition
When you have pancreatitis, your body doesn’t absorb fat and protein from your food as it should. Being in pain may also mean you don’t feel like eating as much. This can lead to malnutrition – which means you’re underweight or not getting enough nutrients.
If you have signs of malnutrition, your doctor or dietitian may suggest making some changes to your diet. This might include eating more frequent but smaller, high-protein and high-calories meals. They can also advise if you should take any vitamin supplements. They may also prescribe pancreatic enzyme replacement therapy. These are supplements that you take with all your meals and snacks. They help you to digest your food better so you get the nutrients your body needs.
Pain management
Your doctor can give you advice on managing any pain you have. For mild pain, this may involve taking over-the-counter painkillers , like paracetamol and ibuprofen. If necessary, your doctor can prescribe a stronger painkiller called tramadol. Your doctor may also suggest taking antidepressant medicines or painkillers for nerve pain. These can work well for pancreatitis pain. If your pain is severe, you may be prescribed an opioid painkiller such as morphine for a short time. Your doctor may refer you to a pain clinic to help find the best way to manage your pain.
Always read the patient information leaflet that comes with your medicine. If you have any questions, ask your GP or pharmacist for advice.
Surgery
If you have certain complications or your pain doesn’t get better with other treatments, your doctor may suggest an operation.
These procedures could include:
- draining any cysts that develop on your pancreas
- putting in a tube (called a stent) to help drain fluid from your pancreas
- removing or destroying gallstones or other stones in your pancreas
- removing parts of your pancreas that are inflamed or damaged
Surgery isn’t a treatment choice for everyone. Your doctor will be able to advise you on the best treatment option for your circumstances.
Complications of pancreatitis
Acute pancreatitis
Most people with acute pancreatitis find their symptoms improve and they feel better within a week of starting treatment. But if you have severe pancreatitis, it can cause serious complications. These can develop days or even weeks after your pancreatitis. Complications of acute pancreatitis include the following.
- Pancreatic necrosis. This is when some of the tissue in your pancreas dies and can become infected. This can be life-threatening if it’s not treated quickly. It may need treatment with antibiotics or a surgical procedure.
- Abscesses. These are collections of pus that can form in your abdomen, usually after a few weeks.
- Pseudocysts. These are fluid-filled cysts that can develop around your pancreas, a few weeks after the pancreatitis. They may need treatment with antibiotics or a catheter to drain them. They sometimes go away by themselves.
More severe cases of acute pancreatitis can lead to other problems around your body. These may include damage to your kidneys, an infection in your blood (sepsis), and problems with your breathing.
Chronic pancreatitis
Complications of chronic pancreatitis can develop over many years. Most people develop some complications eventually.
Complications of chronic pancreatitis include the following.
- Pseudocysts – fluid-filled cysts in your pancreas. These can be painful and can sometimes get infected.
- Problems with digesting or absorbing food, which can lead to malnutrition (not getting enough nutrients). You’ll need to take pancreatic enzyme replacement therapy to manage this.
- Diabetes. This can develop because your pancreas can’t make the hormone insulin. You’ll need to take insulin if you have diabetes.
- Osteoporosis-weakened bones and increased risk of breaking a bone. This is a side-effect of not absorbing enough nutrients.
- Pancreatic cancer. Chronic pancreatitis may increase your risk of developing pancreatic cancer, but the risks are still small. The risk is greater if you have a genetic form of pancreatitis.
You will be advised to have regular screening for diabetes and osteoporosis if you have chronic pancreatitis. This means your doctors can pick up on any problems quickly and arrange treatment.
Prevention of pancreatitis
If you’ve already had an episode of acute pancreatitis, there’s a risk that you may get another one. You may also go on to develop chronic pancreatitis. But there are things you can do to reduce the risk of this happening. These include the following.
- Reducing how much alcohol you drink – or preferably stopping drinking altogether.
- Eating a healthy, balanced, low-fat diet.
- Stopping smoking.
- If you have gallstones, having treatment to remove them.
- If you have high blood lipid levels, treatment to control them may help.
The main symptom of pancreatitis is severe pain in your upper abdomen. This comes on suddenly in acute pancreatitis. You may suddenly start feeling or being sick. You should get medical advice as soon as possible if you have these symptoms. See our Symptoms section for more information.
Pancreatitis can be serious. Most people who get acute pancreatitis (where it comes on suddenly) have a mild illness and recover quickly. But severe acute pancreatitis or chronic pancreatitis can go on to cause complications. These can be serious. You can read about the different types of pancreatitis in our About section.
Gallstones are the most common cause of acute pancreatitis. Alcohol is also a common cause, and is the main cause of chronic pancreatitis. There are other things that can increase your risk such as smoking and certain other conditions. You can find out more in our Causes section.
Gallstones
Gallstones are stones that develop in your gallbladder when chemicals like fats and minerals in your bile (a fluid that helps break down food) harden.
Gallbladder removal
You may need to have your gallbladder removed if you have gallstones or if your gallbladder becomes diseased or damaged.
Effects of smoking
Other helpful websites
Discover other helpful health information websites.
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