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Pancreatitis


Expert reviewer, Dr Yiannis Kallis, Consultant Hepatologist and Gastroenterologist
Next review due August 2021

Pancreatitis is a condition where your pancreas becomes inflamed. It can last for a short time and get better (acute pancreatitis), or for a long time and get gradually worse (chronic pancreatitis).

Diagram of the pancreas and surrounding structures

About pancreatitis

Your pancreas is about 15cm (six inches) long and sits just behind your stomach. It’s part of your digestive system and it produces proteins called enzymes, which help to break down the foods you eat. Your pancreas also produces hormones such as insulin, which helps to control the level of glucose (sugar) in your blood.

If you have a very bad case of acute pancreatitis or your pancreas is constantly inflamed for a long time, it can become damaged and stop working properly.

The most common symptom of pancreatitis is tummy pain, which can sometimes be extremely severe. Pancreatitis is often caused by drinking too much alcohol. Having gallstones can also cause acute pancreatitis.

In the UK, the number of people with pancreatitis is rising, although acute pancreatitis is more common than chronic pancreatitis.

Types of pancreatitis

There are two main types of pancreatitis.

  • Acute pancreatitis usually comes on suddenly and can be mild, moderate or severe. About eight out of 10 people will have it mildly and make a full recovery after a few days. Acute pancreatitis is usually a one-off illness, but it can sometimes come back.
  • Chronic pancreatitis is when your pancreas is constantly inflamed for a long time. This causes scarring which affects how well your pancreas works. If you have chronic pancreatitis, your pancreas isn’t likely to get better, which means you’ll have an ongoing, long-term illness.

Symptoms of pancreatitis

Symptoms of acute pancreatitis

The main symptom of acute pancreatitis is usually severe abdominal (tummy) pain. The pain is usually in the top middle or top left of your abdomen and is constant. The pain can spread to your back, get worse when you move and feel better when you curl into a ball. Some people say it can feel like a stabbing pain.

Other symptoms of acute pancreatitis include:

  • feeling sick and being sick
  • losing your appetite
  • a fast heartbeat, which may happen because you’re in pain

Symptoms of chronic pancreatitis

If you have chronic pancreatitis, you may also have abdominal pain, though it’s more likely to be dull rather than sharp. The pain can be severe and may get worse around half an hour after you eat. Sitting or leaning forwards can sometimes ease the pain.

Other symptoms of chronic pancreatitis include:

  • pale, runny and oily poo that smells bad
  • feeling bloated and passing wind often
  • losing weight
  • feeling sick and being sick
  • symptoms of diabetes, such as feeling very thirsty and needing to pass urine more often

The symptoms of chronic pancreatitis can come and go. Some people have periods of time when they have no symptoms, whereas for others the pain is there all the time. Sometimes chronic pancreatitis starts with several attacks of acute pancreatitis over time.

When to seek medical help

Depending on your symptoms and how severe they are, you may need to see to your GP or you may need hospital treatment straight away. If you have any of the symptoms listed above and are concerned, speak to your GP. But if your symptoms come on quickly and are severe, get medical help straight away because pancreatitis can sometimes cause serious illness.

Diagnosis of pancreatitis

Your doctor will ask about your symptoms, your medical history, and how much alcohol you drink. They’ll examine you and carry out some basic tests such as checking your pulse rate and blood pressure.

If your doctor thinks your symptoms may be caused by pancreatitis, you may need to have some of the following investigations.

  • Blood tests (for example, to test for pancreatic enzymes or diabetes).
  • An X-ray of your chest and abdomen (tummy). This will produce pictures of your pancreas and surrounding organs and can help to clarify if anything else is causing your symptoms.
  • An abdominal ultrasound. This uses sound waves to produce pictures of your organs and can help to show up what may be causing your pancreatitis (for example, gallstones).
  • A CT scan. This uses a series of X-ray images to produce a detailed picture of your pancreas. It can help to show whether or not you definitely have pancreatitis if other tests haven’t been clear enough. It can also tell your doctor how severe your acute pancreatitis is and if this is causing you any further complications.
  • An endoscopic ultrasound. This involves passing a thin, flexible tube called an endoscope with an ultrasound probe attached to it down into your stomach. It uses sound waves to create detailed pictures of your pancreas and surrounding organs.
  • A stool sample. If your doctor thinks you may have chronic pancreatitis, they may test a sample of your poo to check if your pancreatic enzymes are being affected.
  • A type of MRI scan called a magnetic resonance cholangiopancreatogram (MRCP). This creates a detailed picture of your pancreas. It can show any severe damage to your pancreas or if you have any gallstones.
  • An endoscopic retrograde cholangiopancreatography (ERCP). This test produces a detailed X-ray image of your pancreas and bile ducts so your doctor can see what condition they’re in. It’s also often used as a treatment for pancreatitis, because your doctor can take out any gallstones you may have or put tubes (stents) into any blocked ducts during the procedure. During an ERCP, a narrow, flexible, tube-like telescopic camera called an endoscope is passed down into your stomach. A special dye is put down the endoscope to help your doctor see your pancreas clearly. ERCP can sometimes trigger an attack of acute pancreatitis.

Treatment of pancreatitis

Treatment of acute pancreatitis

If you have acute pancreatitis, you’re likely to need treatment in hospital. Your treatment will depend on how severe your pancreatitis is and what’s causing it.

Most people with acute pancreatitis find that their symptoms get much better within a week of starting treatment. But, if your pancreatitis is severe, it can cause other organs such as your kidneys to stop working. If this happens, you’ll need to be treated in intensive care or a high dependency unit.

Resting your pancreas

The main aim of treatment for acute pancreatitis is to prevent or reduce the chance of complications and serious illness from developing. Your doctor will also treat your pain and ease any other symptoms you have such as sickness. This means ‘resting’ your pancreas and bowel to reduce the amount of digestive enzymes made, which will give your pancreas chance to recover.

The main treatments you’re likely to have for acute pancreatitis could include:

  • intravenous fluids given by a drip, through a vein in your arm
  • painkillers – these may include medicines called opiates (for example, morphine) if your pain is severe
  • medicines to treat any sickness you feel
  • insulin injections or an insulin infusion given into your vein if your pancreas is damaged and has stopped producing the hormone insulin
  • antibiotics if you have symptoms of an infection

Gallstone treatment

If your pancreatitis is caused by gallstones, you’ll need to have the gallstones taken out once you’re feeling better. This can be done either by having your gallbladder removed (a cholecystectomy), or during an endoscopic retrograde cholangiopancreatography (ERCP). During an ERCP, your gallstones are taken out using an endoscope (a narrow flexible tube), which is passed down your throat.

Treatment of chronic pancreatitis

The treatment for chronic pancreatitis depends on what’s causing it and what your symptoms are. The main aims of your treatment are to:

  • ease your symptoms and pain
  • help you stay as well as possible
  • manage any complications
  • improve your quality of life

Lifestyle changes

If you’re diagnosed with chronic pancreatitis, you’ll probably be asked to make some changes to your lifestyle. If you smoke or drink alcohol you’ll be asked to stop. This can be difficult without the right support, so your doctor will help you. You may be referred to your local stop-smoking services or to a specialist alcohol service. If your pancreatitis has been caused by drinking too much alcohol, stopping drinking can sometimes help to reduce your pain.

Your doctor may also suggest making some changes to the foods you eat. When you have pancreatitis, your body is using a lot of energy and protein. So your doctor is likely to suggest eating foods that have lots of protein and carbohydrate in them to keep your body well supplied. Eating smaller meals more often may help to stop you losing weight.

Medicines

Your doctor may prescribe the following medicines to help you manage your condition.

  • Painkillers. The type of painkiller your doctor prescribes will depend on how severe your pain is and whether it’s coming and going or always there. If your pain comes and goes, your doctor may suggest you take paracetamol and ibuprofen. If your pain is always there and is severe, your doctor may prescribe you opioid painkillers such as codeine or other medications.
  • Pancreatic enzyme supplements, such as pancreatin. These can help you to digest your food better, get more nutrients from the foods you eat and reduce 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 to treat the underlying cause.

Depending on what’s causing your pancreatitis, these procedures could include:

  • Endoscopic therapies. For example, an endoscopic retrograde cholangiopancreatography (ERCP). During an ERCP, a long, narrow tube with a camera on the end is passed down your throat and creates pictures of your pancreas and its surrounding ducts and organs. This procedure is often used to diagnose pancreatitis, but it can also be used during treatment to remove any blockages like gallstones or to put a stent in to widen your ducts if they’ve become narrowed. If you have developed fluid-filled cysts as a complication of pancreatitis, you may have an endoscopic ultrasound to drain these.
  • Pancreas surgery. Your surgeon may remove the parts of your pancreas that are inflamed.
  • Gallbladder surgery. If your pancreatitis is caused by gallstones, your doctor may suggest having your gallbladder removed (a cholecystectomy).

Surgery isn’t a treatment choice for everyone though. Your doctor will be able to advise you on the best treatment option for your circumstances.

Causes of pancreatitis

The most common cause of both acute and chronic pancreatitis is drinking too much alcohol. Having gallstones can also cause acute pancreatitis. Some medicines can cause acute pancreatitis.

You can develop chronic pancreatitis if you drink too much alcohol regularly. But you’re more likely to get it if you also smoke, eat lots of high-fat foods and members of your close family have had the condition.

High levels of triglycerides (a type of fat) or high levels of calcium in your blood can also cause pancreatitis.

There are other possible causes for acute pancreatitis, such as an infection or injury to your pancreas, or cancer of the pancreas.

For some people with pancreatitis, the exact cause is never found.

Complications of pancreatitis

Complications of acute pancreatitis

Most people with acute pancreatitis find their symptoms improve and they feel better within a week of starting treatment. However, if you have severe pancreatitis, it can cause serious complications, such as:

  • kidney failure – severe pancreatitis can also affect how well other organs work
  • an infection in your blood (sepsis)
  • an abscess
  • cysts filled with fluid which develop around your pancreas
  • not enough blood supply to your pancreas which causes the tissue to die and can lead to an infection

Complications of chronic pancreatitis

The complications of chronic pancreatitis can develop over many years and most people will develop them eventually. You’ll need long-term treatment and care from a team of health professionals to prevent complications from developing wherever possible.

Complications of chronic pancreatitis can include:

  • fluid-filled cysts in your pancreas, which can be painful and can sometimes get infected
  • your pancreas stops making important enzymes that help to digest the food you eat– if this happens, you’ll need to take supplements
  • diabetes – this can develop because your pancreas can’t make the hormone insulin.

There is also a small chance of developing cancer of the pancreas if you have chronic pancreatitis. You can find out more about this in our FAQ: Does chronic pancreatitis lead to pancreatic cancer?

Living with pancreatitis

Chronic pancreatitis can be a difficult condition to live with and it can have a big impact on your day-to-day life, particularly if your symptoms are severe. So, it’s important to get help and support for you and your family.

Many people with the condition have pain all the time, and periods of time when that pain is severe. Constant pain can affect your mood as well as how you feel physically. Some people with chronic pancreatitis also have other long-term conditions such as diabetes to manage.

Because of the effects on your physical and mental health, you may need to take time off work. Or, you might have to stop work completely. Chronic pancreatitis can affect your social and family life. There are organisations that can offer you further support and information about living day to day with pancreatitis. For more on this, see our section: Other helpful websites.

Frequently asked questions

  • The chances of developing cancer of the pancreas are small, especially if you’re under 45. But the longer you’ve had chronic pancreatitis, the more likely you are to develop cancer of the pancreas.

    You’re also more at risk of developing pancreatic cancer if:

    • a close family member has had chronic pancreatitis
    • your chronic pancreatitis was caused by heavy drinking
    • you smoke

    If you’re worried or would like more information about the risks of cancer, speak to your specialist or your GP.

  • If you develop chronic pancreatitis it won’t go away – it can be treated but it can’t be cured. Some people find their pain reduces over time, while others have periods where their pain gets worse. Once your pancreas is damaged, that damage can’t be reversed and your pancreas won’t work properly again. The inflammation that develops gradually damages your pancreas and causes scar tissue to build up. This affects how well your pancreas works and over time it gradually stops making digestive enzymes and insulin. This is why it's important to get the right treatment as quickly as possible to prevent complications.

  • This will depend on how severe your pancreatitis is and whether it’s acute or chronic. Most people with acute pancreatitis are treated in hospital, rather than by their GP. If you have chronic pancreatitis, you’re also likely to have your care at a hospital, but your GP may share some of this care. You may be treated by a specialist team of health professionals or referred to a specialist centre.

    Specialist health professionals you may see include:

    • gastroenterologist – doctors who specialise in treating conditions that affect the stomach and bowels
    • a pancreatic specialist doctor
    • pain specialists who can help you to control pain in the long term
    • addiction services to give you support if your pancreatitis is caused by drinking too much alcohol
    • a dietitian to help you eat well and choose the right foods


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Related information


    • Gastrointestinal medicine. Oxford Handbook of General Practice (Online). Oxford Medicine Online. oxfordmedicine.com, published 2014
    • Pancreas anatomy. Medscape. emedicine.medscape.com, updated December 2017
    • Overview of pancreatitis. The MSD Manuals. www.msdmanuals.com, last full review/revision February 2017
    • Acute pancreatitis. The MSD Manuals. www.msdmanuals.com, last full review/revision February 2017
    • Acute pancreatitis. PatientPlus. patient.info/patientplus, last checked March 2016
    • Chronic pancreatitis. PatientPlus. patient.info/patientplus, last checked March 2016
    • UK guidelines for the management of acute pancreatitis. Gut 2005; 54:iii1–iii9. www.ncbi.nlm.nih.gov
    • Acute pancreatitis. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised May 2016
    • Acute pancreatitis. BMJ Best Practice. bestpractice.bmj.com, last updated November 2017
    • Chronic pancreatitis. BMJ Best Practice. bestpractice.bmj.com, last updated November 2017
    • Chronic pancreatitis. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised June 2016
    • Endoscopic retrograde cholangiopancreatography. PatientPlus. patient.info/patientplus, last checked June 2016
    • Endoscopic ultrasound scan. PatientPlus. patient.info/patientplus, last checked December 2015
    • Acute pancreatitis. Medscape. emedicine.medscape.com, updated February 2017
    • Chronic pancreatitis. Medscape. emedicine.medscape.com, updated November 2017
    • Meier R, Ockenga J, Pertkiewicz M, et al. ESPEN guidelines on enteral nutrition: pancreas. Clin Nutr 2006; 25:275–84. espen.info
    • Machicado JD, Amann ST, Anderson MA, et al. Quality of life in chronic pancreatitis is determined by constant pain, disability/unemployment, current smoking and associated co-morbidities. Am J Gastroenterol 2017; 112(4):633–42. www.ncbi.nlm.nih.gov
    • Pancreatic cancer. BMJ Best Practice. bestpractice.bmj.com, last updated November 2017
    • Alcohol-use disorders: diagnosis and management of physical complications. National Institute for Health and Care Excellence (NICE). 2010. www.nice.org.uk
    • Personal communication, Dr Yiannis Kallis, Consultant Hepatologist and Gastroenterologist, 23 July 2018
  • Reviewed by Michelle Harrison, Specialist Health Editor, Bupa Health Content Team, August 2018
    Expert reviewer, Dr Yiannis Kallis, Consultant Hepatologist and Gastroenterologist
    Next review due August 2021



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