Overview

The pancreas is a gland under the stomach that helps with digestion. Pancreatitis is inflammation or swelling of the pancreas.

Acute pancreatitis is when the pancreas becomes inflamed or swollen over a short time. Symptoms can include:

• severe pain at the top of your tummy (abdomen)
• pain in your back
• feeling sick (nausea) or being sick (vomiting)

The pancreas also produces insulin, which is a hormone that controls the amount of sugar (glucose) in the blood. Severe acute pancreatitis can sometimes cause diabetes. This is a long-term condition when your blood sugar level becomes too high.

Read more about the causes, symptoms, diagnosis, treatment, complications and prevention of acute pancreatitis on the NHS website.

Causes of acute pancreatitis

The most common causes of acute pancreatitis are alcohol or gallstones. These are small stones that form in the gallbladder, which is a small pouch under the liver.

Your pancreas produces juices that travel down a tube called the pancreatic duct. The tube from the liver and gallbladder is called the bile duct. These 2 tubes join together and empty into the intestine. Gallstones can block this tube and the pressure causes inflammation or swelling.

There are many other less common causes. Sometimes, it is not known what causes acute pancreatitis.

Diagnosis

We usually diagnose acute pancreatitis by doing a blood test for a substance called amylase. This is an enzyme (a natural chemical needed to digest food), which your pancreas makes.

In some cases, the amylase level is not very high and you may need a scan to help us make a diagnosis.

Acute pancreatitis often gets better in a few days. However, in 1 out of 5 cases, it can be severe and a life-threatening condition.

It can be difficult to tell if acute pancreatitis is mild or severe. We do blood tests to try to predict if your case is mild or severe.

Treatment

You will be managed by the hospital in mild or severe acute pancreatitis.

Mild acute pancreatitis

If you have mild acute pancreatitis, you may be admitted to hospital until you feel better. Sometimes people do not need to be admitted but monitored closely as an outpatient. 

In hospital we may give you fluids through a small tube into a vein (an intravenous or IV fluid drip). This is to stop you getting dehydrated.

We give you painkillers to help with tummy pain. We also do tests to find the cause of the acute pancreatitis. You usually have an ultrasound or MRI scan of your tummy.

Most people with pancreatitis can eat and drink as usual, unless you are waiting for a test that needs your stomach to be empty.

If you feel sick and can't eat, we might give you special drinks. Occasionally you may need liquid food through a tube in your nose that goes into your stomach. This is called a naso-gastric tube, NG tube or enteral feeding. 

You might need a urinary catheter. This is a flexible tube used to empty the bladder and collect pee (urine) in a drainage bag. We can then measure how much urine you make.

Sometimes, you might need a special procedure to examine and clear the tubes from the pancreas and gallbladder. This procedure is called an endoscopic retrograde cholangio pancreatogram (ERCP). 

If we find gallstones, we usually recommend surgery to remove the gallbladder. We might do this during your same stay in hospital or soon afterwards. Your doctor talks to you about this in more detail.

Severe acute pancreatitis

Severe acute pancreatitis can cause complications that are life-threatening.

You are often treated in the high dependency unit (HDU) or intensive care unit (ICU). We can then support your organs if you have problems with breathing or how your kidneys work, or your blood pressure is low.

People with severe acute pancreatitis can be in hospital for many days, weeks or even months. This depends on how much inflammation you have and how it affects other organs.

You might need several scans and we might need to put drainage tubes into the pancreas. We do this under the guidance of an X-ray. Rarely, you might need surgery to remove the damaged pancreas.

Surgery to remove the gallbladder

If you need surgery to remove the gallbladder, this helps to prevent acute pancreatitis from returning.

We do the surgery to remove your gallbladder as soon as possible if you have mild acute pancreatitis. If you have severe acute pancreatitis, we usually wait a few weeks before doing the surgery. This gives time for the inflammation to get better.

Preventing acute pancreatitis

If alcohol has caused acute pancreatitis, it is best to stop drinking alcohol completely. This reduces the chance of getting acute pancreatitis again. The condition might be more severe in the future.

We recommend that you do not drink alcohol for several months after having severe acute pancreatitis. This applies even if alcohol did not cause the condition.

Read more about drinking less and other ways to stay healthy.

If the cause of your acute pancreatitis is not obvious, we will see you in our outpatients clinic. You have more tests to find if there is a cause that we can treat to prevent another attack of acute pancreatitis.

Some people get more attacks of acute pancreatitis. This is called recurrent acute pancreatitis. If this happens, contact you GP or visit your nearest emergency department (A&E).

A small number of people might get chronic pancreatitis. This is a condition where the pancreas does not work well and you have repeated episodes of severe pain in your tummy.