Acute pancreatitis

Acute pancreatitis occurs when your pancreas becomes inflamed for a short period of time. This is different to chronic pancreatitis, where your pancreas becomes permanently damaged from inflammation.

Key points

Your pancreas is a small organ located behind your stomach and below your ribcage. It is a part of your digestive system. It secretes enzymes, or digestive juices, into your small intestine to further break down food after it has left your stomach. It also secretes the hormone insulin into your bloodstream to regulate your glucose or sugar levels.

The main symptom of acute pancreatitis is pain in your abdomen. It usually settles within a few days, but sometimes the pain is severe and the condition can be serious.

Acute pancreatitis is most often linked to gallstones, which account for about half of cases, and alcohol, which accounts for about a quarter of cases.1

Acute pancreatitis is more common in middle-aged and elderly people, but it can affect people of any age. Men are more likely to develop alcohol-related pancreatitis, while women are more likely to develop it because of gallstones.1  

While most people can be treated, and will recover from acute pancreatitis, one in five people have a severe case of it, which can result in life-threatening complications, such as multiple organ failure. Where such complications develop, there's a high risk of the condition being fatal.1

There is also a high chance that people who suffer ongoing bouts of acute pancreatitis will eventually go on to develop chronic pancreatitis.2

Contact your GP immediately if you suddenly develop severe abdominal pain. If this isn't possible, phone 111 or go to your local A&E department.

What are the causes of acute pancreatitis?

Acute pancreatitis is caused:

  1. When a gallstone gets stuck in the bile duct or where the bile duct and pancreatic duct open into the small intestine. This affects or even blocks the enzymes (chemicals) enzymes in the pancreatic duct.
  2. As the result of a bout of heavy drinking, usually about six to 12 hours later, although why this happens is unclear.3

Rare causes include viral infections, injury or surgery around the pancreas, autoimmune disease, medicine4 or colonoscopy.5

What are the symptoms of acute pancreatitis?

The main symptom of acute pancreatitis is suddenly getting a severe pain in the middle of your abdomen (tummy) just below your ribs. This pain often gets increasingly worse, and it sometimes moves towards your back and up to just below your left shoulder blade. You may feel worse when you eat or drink, especially fatty foods. Lying flat on your back often makes the pain worse. Leaning forward or curling into a ball may help to relieve the pain.¹ 

You may also experience:

  • feeling sick (nausea) or being sick (vomiting)
  • a high temperature (fever)
  • your abdomen swelling
  • diarrhoea (runny poo).

How is acute pancreatitis diagnosed?

You will be admitted to hospital, where doctors will find out the cause of your severe abdominal pain and vomiting. You are likely to have blood tests and an ultrasound.

What is the treatment for acute pancreatitis?                      

If you experience severe pain, you will be admitted to hospital, where you are likely to be given pain relief medicine, as well as fluids into your veins (intravenous fluids) to prevent dehydration. To give your pancreas time to recover, you may be advised not to eat solid food for a few days. Once the inflammation in your pancreas is controlled, you may begin drinking clear liquids and eating bland foods. With time, you can go back to your normal diet. Depending on the severity of your condition, a feeding tube may be used to provide your body with nutrients. This involves inserting a tube through your nose (nasogastric tube) into your stomach.

If the cause is a gallstone, you may need a procedure to remove it, and if the area around your pancreas gets infected you may need to take antibiotics.

Most people with acute pancreatitis improve within a week and are well enough to leave hospital after five to 10 days.

What self-care can I do if I have acute pancreatitis?

Even if alcohol was not the cause of your acute pancreatitis, stopping drinking alcohol is important in the short term, and if alcohol was the cause, for the long term.

If a gallstone was the trigger, then changing to a low-fat diet may make gallstones less likely.

Support

There are online support groups for people with chronic pancreatitis, such as Facebook support group for chronic and acute pancreatitis,

Can I prevent acute pancreatitis?

A healthy lifestyle can help prevent this condition. To avoid developing gallstones, eat a healthy diet that is high in fibre and low in fatty foods, and limit the amount of alcohol you drink.

Learn more

Acute pancreatitis NHS Choices, UK, 2015
Acute pancreatitis Patient Info, UK, 2016
Alcohol and problem drinking Health Navigator, New Zealand, 2015
Gallstones diet sheet Patient Info, UK, 2017 

References

  1. Acute pancreatitis NHS Choices, UK, 2015
  2. The University of Auckland. World leading research bad news for pancreatitis sufferers. 2015. auckland.ac.nz/en/about/news-events-and-notices/news/news-2015/09/world-leading-research-bad-news-for-pancreatitis-sufferers.html
  3. Acute pancreatitis Patient Info, UK, 2016
  4. Tatley M. Drug-induced pancreatitis: An unlucky DIP. MedSafe Prescriber Update 2005;26(2):32-33. medsafe.govt.nz/profs/PUarticles/pancreatitis.htm
  5. Khashram M, Frizelle FA. Colonoscopy—a rare cause of pancreatitis. 2011 Nov;124(1345). nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2011/vol-124-no-1345/cc-khashram

 

Credits: Julie O'Brien. Reviewed By: Sandra Ponen