acute pancreatitis

Acute pancreatitis is an inflammation in the pancreas. The pancreas is an organ behind the stomach and connected to the bowel. It produces enzymes, which are necessary to break down food during digestion, and helps regulate the body’s glucose levels by producing the hormones insulin and glucagon.

There are several causes of acute pancreatitis. Some of the most common causes are drinking large amounts of alcohol, gallstones, and certain medications. Typical symptoms of acute pancreatitis are a pain in the upper part of the abdomen and the back, as well as nausea and vomiting. Treatment involves rest, fluids, and treating the underlying cause.

Around 275,000 people in the United States are hospitalized with acute pancreatitis each year. It is a serious condition, but most people recover well, once the underlying cause is recognized and treated.^[1]

Acute pancreatitis vs chronic pancreatitis

Acute pancreatitis can be treated and will fully resolve in a few days. Chronic pancreatitis does not heal, worsens over time, and causes permanent damage to the pancreas. Chronic pancreatitis can be debilitating and lead to death. Repeated episodes of acute pancreatitis may lead to chronic pancreatitis.^[2]

Symptoms of acute pancreatitis

The main symptom of acute pancreatitis is a pain in the upper abdomen, that may then spread to the back. This pain can:^[3]^[4]^[5]

Be severe enough to require strong painkillers
Appear suddenly, where the cause is gallstones
Appear one to three days following a drinking binge or stopping drinking, where the cause is alcohol
Persist for several days
Be made worse by coughing, deep breathing and moving vigorously
Sometimes be eased by leaning forward

Other symptoms of acute pancreatitis include:

Nausea and vomiting
Fever
Loss of appetite
Elevated heart rate
Tender abdomen
Blue/gray skin discoloration around the sides, also known as the Grey Turner sign or ecchymoses of the flanks
Blue/gray skin discoloration around the navel, also known as the Cullen sign or ecchymoses of the flanks

People experiencing possible symptoms of acute pancreatitis should consult a doctor.

Causes of acute pancreatitis

Sixty to seventy-five percent of acute pancreatitis cases are caused by gallstones or a high intake of alcohol. There is no identifiable cause for around 20 percent of acute pancreatitis cases; this is known as idiopathic pancreatitis.^[5]

Gallstones

Gallstones can trigger acute pancreatitis by blocking the drainage duct shared by the pancreas and the gallbladder. This stops pancreatic enzymes from flowing normally and causes pancreatitis.^[5]

Alcohol use

Heavy alcohol use over a prolonged period can cause acute pancreatitis. It is unclear how alcohol causes pancreatitis, though there are theories that alcohol may convert into chemicals that damage the pancreas, or that alcohol blocks the pancreatic duct.^[3]

The risk of pancreatitis increases with heavy alcohol use, which is considered to be:

Four to seven drinks a day for men
Three or more drinks a day for women

If a person with acute pancreatitis drinks less than these amounts, the condition may still progress to chronic pancreatitis. Alcohol should be completely avoided while undergoing treatment for acute pancreatitis.

Cystic fibrosis

Cystic fibrosis is a genetic disorder that causes some glands to function abnormally. In people with cystic fibrosis, the pancreas produces secretions that can block the gland. Having cystic fibrosis increases the risk of repeatedly developing acute pancreatitis and also increases the risk of developing chronic pancreatitis.^[3]^[6]

Medications

The following medications may cause acute pancreatitis as an uncommon, but potentially severe side effect:^[3]

Angiotensin-converting enzyme (ACE) inhibitors, used to treat hypertension and heart failure
Azathioprine, used in kidney transplants and for rheumatoid arthritis
Furosemide, used to treat hypertension
6-mercaptopurine, used to treat acute lymphocytic leukemia
Pentamidine, used to treat pneumonia
Sulfonamides, a class of synthetic antibiotics
Valproate, used to treat seizures and bipolar disorder

Endoscopic retrograde cholangiopancreatography (ERCP)

Three to five percent of people who have a procedure called endoscopic retrograde cholangiopancreatography (ERCP) go on to develop acute pancreatitis. ERCP uses an endoscope, which is a flexible tube inserted into the esophagus, stomach, and intestine to examine the bile and pancreatic ducts.^[7]

Other causes of pancreatitis

Less common causes of pancreatitis include:^[4]^[8]^[9]

Mumps
Mononucleosis/Epstein-Barr virus
HIV
Parasitic infection, such as ascariasis, toxoplasmosis or cryptosporidium
High cholesterol levels
Pancreatic cancer

Diagnosis of acute pancreatitis

Diagnosis of acute pancreatitis is based on the symptoms and a physical examination. A diagnosis will generally be confirmed if two of the following three symptoms are present:^[5]

Abdominal pain
Increases of amylase and lipase levels in the blood that are threefold or higher
Inflamed pancreas, seen on a CT scan or MRI scan

Blood tests may be ordered to investigate if the pancreas is working properly and to look for signs of inflammation. Blood tests can check for:^[3]^[10]

High levels of digestive enzymes made by the pancreas, called amylase and lipase
High blood glucose levels
High levels of blood fats, called lipids
Signs of infection
Pancreatic cancer

Read about how to interpret Blood Test Results

Imaging scans can be used to diagnose acute pancreatitis and also to identify complications such as necrosis, death of living tissue, or fluid collection. Scans that may be performed include:^[3]^[10]

Computed tomography (CT) scan, to create a picture of the pancreas, gallbladder and bile ducts
Magnetic resonance imaging (MRI), another method of creating a picture of the pancreas, gallbladder and bile ducts
Ultrasound, which can be used to identify gallstones

Treatment of acute pancreatitis

Acute pancreatitis is a serious condition and can lead to complications such as fluid-filled pseudocysts, damage to the pancreas, and heart and lung or kidney failure. However, with appropriate treatment, most people recover well.^[1]^[11]

People with acute pancreatitis are usually admitted to the hospital. Treatment generally includes:

Fluids administered intravenously
Painkillers
Drugs to reduce nausea and vomiting
Feeding by tube or intravenously if the person cannot eat
Antibiotics, if the person has an infection in the pancreas

Treatment for acute pancreatitis caused by gallstones

If acute pancreatitis is caused by gallstones, this condition also needs to be treated. There are various options to treat gallstones:

Surgical removal of the gallbladder. This is a common procedure and will prevent acute pancreatitis caused by gallstones recurring.^[12]

Non-surgical options to eliminate gallstones may be possible where a person is unable to have their gallbladders removed, such as because of old age or other medical conditions. However, without gallbladder removal, acute pancreatitis caused by gallstones is likely to recur in 30 to 50 percent of cases.^[12]

Non-surgical options for eliminating gallstones include:^[12]^[13]

Bile acid pill, to break down small gallstones caused by cholesterol
Endoscopic retrograde cholangiopancreatography (ERCP), to remove gallstones from the bile duct
Shock wave lithotripsy, a rarely offered procedure which uses shock waves to break up larger gallstones

Preventing acute pancreatitis

Eating a healthy diet that is rich in fiber, fruits, vegetables, and whole grains and avoiding unhealthy fats can reduce the risk of developing gallstones.^[14]

Stopping drinking alcohol and stopping smoking can help prevent future episodes of acute pancreatitis and prevent progression to chronic pancreatitis.^[15]

Acute pancreatitis FAQs

Other names for acute pancreatitis

Acute pancreatic necrosis

National Institute of Diabetes and Digestive and Kidney Diseases. “Definition & Facts for Pancreatitis.” November 2017. Accessed June 30, 2018. ↩ ↩
MedlinePlus. “Chronic pancreatitis.” September 2017. Accessed June 30, 2018. ↩
MSD Manual: Professional Version. “Acute Pancreatitis.” February 2017. Accessed June 30, 2018. ↩ ↩ ↩ ↩ ↩ ↩
National Institute of Diabetes and Digestive and Kidney Diseases. “Symptoms & Causes of Pancreatitis.” November 2017. Accessed June 30, 2018. ↩ ↩
UpToDate. “Acute pancreatitis.” May 2018. Accessed June 30, 2018. ↩ ↩ ↩ ↩
MSD Manual: Consumer Version. “Cystic Fibrosis.” Accessed June 30, 2018. ↩
UpToDate. “ERCP (endoscopic retrograde cholangiopancreatography).” May 2018. Accessed June 30, 2018. ↩
US National Library of Medicine. “Review of Infectious Etiology of Acute Pancreatitis.” June 2017. Accessed June 30, 2018. ↩
US National Library of Medicine. “Pancreatic cancer causing acute pancreatitis: a comparative study with cancer patients without pancreatitis and pancreatitis patients without cancer.” August 2013. Accessed June 30, 2018. ↩
National Institute of Diabetes and Digestive and Kidney Diseases. “Diagnosis of Pancreatitis.” November 2017. Accessed June 30, 2018. ↩ ↩
MedlinePlus. “Pancreatic pseudocyst.” October 2017. Accessed June 30, 2018. ↩
UpToDate. “Gallstones.” May 2018. Accessed June 30, 2018. ↩ ↩ ↩
National Institute of Diabetes and Digestive and Kidney Diseases. “Treatment for Gallstones.” November 2017. Accessed June 30, 2018. ↩
National Institute of Diabetes and Digestive and Kidney Diseases. “Eating, Diet, & Nutrition for Gallstones.” November 2017. Accessed June 30, 2018. ↩
National Institute of Diabetes and Digestive and Kidney Diseases. “Treatment for Pancreatitis.” November 2017. Accessed June 30, 2018. ↩
American Cancer Society. “Pancreatic Cancer Risk Factors.” March 2016. Accessed June 30, 2018. ↩

**Question: What is Acute Pancreatitis?**

**Answer:**

Acute ‍pancreatitis is a sudden inflammation and swelling of the pancreas, a glandular organ located behind the stomach. It is a serious⁣ medical condition that requires immediate ‌medical attention.

**Symptoms of Acute Pancreatitis**

Symptoms of acute pancreatitis typically appear suddenly and may include:

* Intense abdominal pain in ⁤the upper abdomen that radiates to the back

* Nausea and vomiting

*⁣ Fever and‌ chills

* Rapid heart rate

* Abdominal tenderness and bloating

* ⁣Clay-colored⁣ or grayish ⁢stools

**Causes of Acute Pancreatitis**

The most common‍ causes of acute pancreatitis are:

* Gallstones

* Heavy alcohol consumption

* Certain ⁢medications (e.g., azathioprine, mercaptopurine, antibiotics)

* Trauma

* Metabolic conditions (e.g., hypertriglyceridemia)

**Complications of⁤ Acute Pancreatitis**

If left untreated, acute⁢ pancreatitis can lead to serious complications, including:

* Infection

* Blood clots

* Necrosis (death of pancreatic tissue)

* Kidney‍ failure

* Lung failure

**Diagnosis of Acute Pancreatitis**

Diagnosis of acute pancreatitis is based on:

* Medical history and physical examination

* Blood tests: Elevated levels of pancreatic enzymes (e.g., amylase, lipase) indicate inflammation

* Imaging tests: Abdominal CT‌ scans or MRI can confirm pancreatitis and assess severity

**Treatment⁤ for Acute Pancreatitis**

Treatment for acute pancreatitis focuses on managing symptoms and preventing complications:

* Pain relievers

* Intravenous (IV) fluids

*‍ Antibiotic therapy for infections

* Surgery ⁢to remove gallstones or necrotic pancreatic tissue in severe cases

**Prevention ⁣of Acute⁣ Pancreatitis**

There are no guaranteed ways⁤ to prevent acute⁣ pancreatitis, but⁤ certain lifestyle choices can reduce the risk:

* Maintain a healthy weight and diet

* Limit alcohol consumption

*⁤ Avoid smoking

* Seek immediate medical attention⁣ for any abdominal pain

What is Acute Pancreatitis?

acute pancreatitis

Acute pancreatitis vs chronic pancreatitis

Symptoms of acute pancreatitis