The pancreas is a flat gland situated behind your stomach and anterior to the vertebral column. It packs a powerful one-two punch in the digestive system, having both exocrine and endocrine function as follows.
1. Enzyme Production: It produces digestive enzymes that break down proteins, carbohydrates, and fats in your small intestine. These enzymes are crucial for proper nutrient absorption.
2. Hormone Regulation: It also produces hormones like insulin and glucagon, which regulate blood sugar levels.

Inflammation and its Causes

Acute pancreatitis occurs when the pancreas becomes inflamed. This inflammation disrupts its normal function, causing the digestive enzymes to activate prematurely within the pancreas itself, essentially leading to self-digestion. The severity of the inflammation determines the course of the disease.

Several factors can trigger this inflammatory response:

  • Gallstones: Gallstones can lodge in the common bile duct, blocking the flow of bile and pancreatic enzymes. This backup can inflame the pancreas.
  • Alcohol Abuse: Heavy alcohol consumption over time can damage and inflame the pancreas. Sometimes, even a single drink can trigger an episode of acute pancreatitis.
  • Other Causes: While less common, other potential triggers include certain medications, autoimmune diseases like lupus, infections (mumps), high blood triglyceride levels, and even some surgical procedures.

Recognizing the Signs & Symptoms of Acute Pancreatitis

The hallmark symptom of acute pancreatitis is severe upper abdominal pain that comes on suddenly and intensifies rapidly. This pain can radiate towards the back, often described as a boring or gnawing sensation. Here are some other telltale signs:

  • Nausea and vomiting
  • Loss of appetite
  • Fever
  • Rapid heart rate
  • Feeling unwell or malaise
  • Abdominal swelling (in severe cases)

The pain often worsens with eating or drinking, and sitting hunched forward may provide some relief.

Diagnosis

Doctors diagnose acute pancreatitis by combining several approaches:

  • Symptoms and Medical History: A detailed discussion of your symptoms and any history of risk factors like gallstones or alcohol abuse is crucial.
  • Blood Tests: Levels of pancreatic enzymes (amylase and lipase) in your blood are typically elevated (to more than thrice the upper limit of normal) during an attack.
  • Imaging Tests: Imaging techniques like ultrasound, CT scan, or MRI scan help visualize the pancreas and identify gallstones, inflammation, or complications.

Treatment Options

The primary goal of treatment is to manage the inflammation and give your pancreas a chance to heal.

  • Pain Management: This is a top priority. Medications and pain management techniques can help alleviate the discomfort.
  • Resting the Pancreas: You will likely be advised to stop eating and drinking initially to allow your pancreas to rest. Fluids will be provided intravenously to keep you hydrated.
  • Medications: Medications may be given to control nausea and vomiting and address any underlying causes like gallstones.
  • Supportive Care: Depending on the severity, hospitalization and intensive care may be necessary.

Prognosis and Prevention

Thankfully, with prompt diagnosis and treatment, most cases of acute pancreatitis resolve within a few days. However, early intervention is key to prevent complications like:

  • Infections: The inflamed and damaged pancreas becomes susceptible to infection.
  • Fluid Collections: Pockets of fluid filled with digestive enzymes or blood can form around the pancreas.
  • Nutritional Deficiencies: Difficulty digesting nutrients can lead to malnutrition.
  • Chronic Pancreatitis: In a small subset of susceptible individuals, repeated episodes of acute pancreatitis can lead to chronic pancreatitis, a permanent condition with ongoing inflammation and pancreatic damage.

Prevention methods

Here are some lifestyle modifications that can help reduce your risk of acute pancreatitis:

  • Alcohol Consumption: Limit alcohol intake or abstain completely if you have a history of pancreatitis.
  • Maintain a Healthy Weight: Obesity is a risk factor.
  • Eat a Healthy Diet: Choose a balanced diet low in fat and processed foods.
  • Follow Doctor's Orders: If you have gallstones, get them removed as advised by your doctor to prevent recurrent biliary problems or pancreatitis. .

Around 80-85% of acute pancreatitis are mild and self limiting. Severe pancreatitis defined by the presence of organ failure (especially that persists for more than 48 hours) becomes a potentially life-threatening condition that requires ICU care, prolonged hospitalization for recovery.

If you experience any symptoms suggestive of acute pancreatitis, seek immediate medical attention. Early diagnosis and institution of goal directed treatment can optimize outcome.

Disclaimer: The views expressed in this article are of the author and not of Health Dialogues. The Editorial/Content team of Health Dialogues has not contributed to the writing/editing/packaging of this article.
Dr Kishore GSB
Dr Kishore GSB

Dr Kishore GSB (MBBS, MS (General Surgery), DNB (General Surgery), MCh (Surgical Gastroenterology), M. HPB Surgery) is a Senior Consultant and Clinical Lead (HPB Surgery and Liver Transplantation) at Fortis Hospital, Bangalore. He has over 17 years of experience in the field of HPB Surgery. He specialises in Liver Transplant, Hepatobiliary Sciences and more.

Dr Piyush Kumar Sinha
Dr Piyush Kumar Sinha

Dr Piyush Kumar Sinha (MBBS, MS (General Surgery), MCh (Hepato Pancreato Biliary Surgery), AFAMS) is a Senior Consultant, Department of HPB Surgery & Liver Transplantation at Fortis Hospital, Bengaluru. He has over 12 years of experience in the field of liver transplantation and has been actively involved in more than 700 liver transplant surgeries.