Pancreatitis is an inflammatory condition that affects the pancreas—a long, flat gland located behind the stomach that plays a critical role in digestion and blood sugar regulation. Each year in the United States, tens of thousands of people are hospitalized due to pancreatitis. The severity of this disease ranges from mild episodes that resolve on their own to life-threatening attacks requiring intensive medical care.

Pancreatitis can be short-term (acute) or long-lasting (chronic), and the treatment approach varies significantly depending on the type and the cause.

Types of Pancreatitis

Pancreatitis is broadly classified into two main categories: acute and chronic.

Acute Pancreatitis This is a sudden inflammation that lasts for a short time. It often comes on quickly, with symptoms such as severe abdominal pain and vomiting. Most people recover completely after treatment, but around 10% of cases can become severe and cause life-threatening complications.

Chronic Pancreatitis This form involves long-term inflammation that results in permanent damage and scarring of the pancreas. It may develop after repeated episodes of acute pancreatitis or appear without prior warning. Over time, the damage may impair pancreatic function and lead to digestive problems and diabetes.

Symptoms

Pancreatitis symptoms vary depending on whether the condition is acute or chronic, and whether complications arise.

From Inflammation

  • Upper abdominal pain that may radiate to the back

  • Nausea and vomiting

  • Fever and increased heart rate (in acute cases)

From Complications

  • Kidney failure

  • Pancreatic necrosis (death of pancreatic tissue)

  • Sepsis, a potentially fatal systemic infection

From Reduced Pancreatic Function

  • Greasy or oily stools

  • Chronic diarrhea

  • Unintentional weight loss

  • Type 3c diabetes due to insufficient insulin production

Causes

The inflammation in pancreatitis is triggered when pancreatic enzymes begin to digest the pancreas itself instead of aiding digestion in the small intestine.

Common Causes Include:

  • Gallstones: These block the pancreatic ducts, leading to backup and inflammation.

  • Heavy alcohol consumption: A major cause of acute and chronic cases.

  • Hypertriglyceridemia: Elevated levels of blood fats.

  • Certain medications: Some drugs may trigger pancreatitis as a side effect.

  • Injuries: Blunt abdominal trauma can lead to pancreatic inflammation.

  • Genetic disorders: Inherited traits may predispose individuals to chronic pancreatitis.

  • Infections: Rare viral infections like mumps or pneumonia.

  • Pancreatic tumors: Though rare, they may obstruct ducts and cause inflammation.

Risk Factors

A number of lifestyle and genetic factors increase the risk:

  • Smoking

  • Heavy alcohol use

  • High-fat diet

  • Family history of pancreatitis

  • Certain gene mutations (PRSS1, SPINK1, CFTR, CTRC, CPA1)

Diagnosis

Diagnosing pancreatitis involves a combination of clinical evaluation, laboratory tests, and imaging.

Blood Tests:

  • Amylase and Lipase: Elevated levels (three times normal) strongly indicate acute pancreatitis.

  • Bilirubin: Assesses possible bile duct obstruction.

  • Complete Blood Count and Metabolic Panel: Helps monitor kidney function, glucose, and electrolytes.

Imaging:

  • CT Scan: Offers detailed views of the pancreas and surrounding organs.

  • MRI: Useful for detecting tissue damage.

  • Ultrasound: Can identify gallstones or duct obstructions.

  • ERCP or MRCP: Specialized techniques to assess and treat bile or pancreatic duct issues.

For chronic cases, stool analysis and specific blood tests may show poor enzyme output.

Treatment

Treatment depends on the type, severity, and underlying cause.

Acute Pancreatitis

  • Hospitalization and monitoring

  • IV fluids and electrolyte balance

  • Pain management with NSAIDs or opioids

  • Nutritional support (oral or feeding tube)

  • Oxygen support if needed

Severe Cases

  • ICU admission

  • Dialysis for kidney failure

  • Mechanical ventilation

  • Surgical removal or drainage of necrotic tissue

  • ERCP to remove gallstones or relieve duct obstruction

Chronic Pancreatitis

  • Long-term pain control

  • Enzyme supplements for digestion

  • Dietary modifications: low-fat, frequent meals

  • Nerve block procedures (e.g., celiac plexus block)

  • Surgery or stent placement to relieve obstructions

Managing Diabetes and Malabsorption

  • Insulin therapy for pancreatogenic diabetes

  • Vitamin supplements (A, D, E, K)

  • Oral pancreatic enzyme replacement

Prevention

While not all cases are preventable, the following steps can reduce your risk:

  • Limit or avoid alcohol consumption

  • Quit smoking

  • Maintain healthy cholesterol and triglyceride levels

  • Eat a fiber-rich diet and reduce processed carbs

  • Maintain a healthy weight

  • Manage gallstones proactively, possibly via gallbladder removal surgery

Crash diets and rapid weight loss should be avoided, as they can trigger gallstone formation.

Related Conditions

Pancreatitis can increase the risk of several serious conditions:

Type 3c Diabetes

  • Occurs when pancreatic insulin production is severely impaired

  • May affect 15–40% of people with pancreatitis

Pancreatic Cancer

  • Risk is elevated in individuals with chronic pancreatitis

Osteoporosis

  • Due to poor absorption of calcium and vitamin D

Living With Pancreatitis

About 20% of individuals who experience an initial attack of pancreatitis will have recurring episodes. Half of those may develop chronic pancreatitis over time.

Effective long-term management includes:

  • Avoiding alcohol and tobacco

  • Following a low-fat diet

  • Regular follow-ups with a gastroenterologist

  • Adhering to prescribed enzyme or insulin therapy

  • Joining support groups or seeking mental health support

Living with chronic pain or digestive discomfort can be challenging, but with a comprehensive care plan, many individuals maintain a good quality of life.