Pancreatitis is when your pancreas becomes inflamed, which can stop it working properly. There are two types of pancreatitis – acute and chronic.
Your pancreas is about 15cm (six inches) long and sits just behind your stomach. It’s part of your digestive system and it makes enzymes which help to break down the foods you eat. It also makes insulin, which helps to control the level of glucose (sugar) in your blood.
Severe acute pancreatitis and chronic pancreatitis can both damage your pancreas and stop it working properly.
Globally the number of people with pancreatitis is going up. Acute pancreatitis is more common than chronic pancreatitis.
There are two main types of pancreatitis.
The main symptom of acute pancreatitis is usually severe abdominal (tummy) pain. The pain is often in the top middle or top left of your abdomen and is constant. It can spread to your back, get worse when you move, and feel better when you curl into a ball. Some people say it feels like being stabbed with a knife.
Other symptoms of acute pancreatitis include:
If you have chronic pancreatitis, you’re likely to have a dull abdominal pain. The pain can spread through to your back and may get worse around half an hour after you eat. Sitting or leaning forwards can sometimes ease the pain.
Other symptoms of chronic pancreatitis include:
The symptoms of chronic pancreatitis can come and go. Some people have periods of time when they have no symptoms, whereas for others the pain is there all the time.
If your symptoms come on quickly and are severe, get medical help straight away because pancreatitis can sometimes cause serious illness. If you have any of the symptoms listed above and are concerned, speak to your doctor.
Finding the cause of pancreatitis is important so that preventative treatment or advice can be given. Your doctor will ask about your symptoms, your medical history, and how much alcohol you drink. They’ll examine you and carry out some basic tests such as checking your pulse rate and blood pressure.
If your doctor thinks your symptoms could be caused by pancreatitis, you may need to have some of the following investigations.
If your symptoms don’t get better or your doctor needs to rule out other conditions, you may need other investigations such as a CT scan.
If you have acute pancreatitis, you’re likely to need treatment in hospital. Your treatment will depend on how severe the pancreatitis is and what’s causing it.
Most people find that their symptoms get much better within a week of starting treatment. But, if your pancreatitis is severe, it can cause other organs – for example, your kidneys – to stop working. If this happens, you’ll need to be treated in intensive care or a high dependency unit.
The main aim of treatment is to prevent or reduce the chance of complications and serious illness from developing. Your doctor will also treat your pain and ease any other symptoms such as sickness. You’ll probably be asked not to eat anything for a day or so. This helps your bowel to ‘rest’ by reducing the amount of digestive enzymes made. That will give your pancreas chance to recover.
The main treatments you’re likely to have for acute pancreatitis include:
Gallstones
If your pancreatitis is caused by gallstones, you’ll need to have them taken out once your symptoms have improved. This can be done either by having your gallbladder removed (a cholecystectomy) or during an endoscopic retrograde cholangiopancreatography (ERCP). During an ERCP, your gallstones are taken out using an endoscope (a narrow flexible tube), which is passed down your throat.
The treatment for chronic pancreatitis depends on what your symptoms are and if you have any complications. The main aims of your treatment are to:
You’re likely to have your care at a hospital but your doctor may share some of this care. You may be treated by a specialist team of health professionals including a gastroenterologist, dietician and pain specialist.
Lifestyle changes
If you smoke or drink alcohol, you’ll probably be asked to stop. Doing this can sometimes help to reduce pain. Giving up smoking or drinking can be difficult without the right support, so your doctor will help you. You may be referred to your local stop-smoking services or to a specialist alcohol service.
Your doctor or dietician may also suggest making some changes to the foods you eat. When you have pancreatitis, your body can’t get as much of the nutrients and energy out of your food as it should. Being in pain and feeling less like eating can also affect your weight. So, your doctor is likely to suggest eating five or six meals a day that are high in protein and energy to keep your body well supplied.
Medicines
Your doctor may prescribe the following medicines to help you manage your condition.
If you have any questions, ask your doctor or pharmacist for advice.
Surgery
If you have certain complications from pancreatitis or your pain doesn’t get better with other treatments, your doctor may suggest an operation to treat the underlying cause.
These procedures could include:
Surgery isn’t a treatment choice for everyone. Your doctor will be able to advise you on the best treatment option for your circumstances.
Gallstones are the main cause of acute pancreatitis and around half of all people with the condition have them. Drinking too much alcohol is the other main cause.
The most common cause of chronic pancreatitis is drinking too much alcohol. If you smoke and eat lots of high fat foods, you’re also more likely to develop chronic pancreatitis.
Most people with acute pancreatitis find their symptoms improve and they feel better within a week of starting treatment. However, if you have severe pancreatitis, it can cause serious complications, such as:
Complications can develop over many years and most people develop them eventually. You’ll need long-term treatment and care from a team of health professionals to prevent complications from developing wherever possible.
Complications can include:
There is also a small chance of developing cancer of the pancreas. For more information on this, see our FAQ: Does chronic pancreatitis lead to pancreatic cancer?
Chronic pancreatitis can be a difficult condition to live with, and it can have a big impact on your day-to-day life especially if your symptoms are severe. So, it’s important to get help and support for you and your family.
Many people with the condition have pain all the time, and periods of time when that pain is severe. Sometimes, it can be difficult to manage and you may need to be referred to a specialist pain clinic. Constant pain can affect your mood as well as how you feel physically, so you need to look after your mental health too. It’s important to get support which helps you to manage day to day and when things are difficult.
You might find it helpful if your doctor refers you to a pancreas specialist to help you manage your condition.
The chances of developing cancer of the pancreas are small, especially if you’re under 45. Around five in 100 people with chronic pancreatitis will develop cancer of the pancreas.
You may be more likely to develop pancreatic cancer if you smoke or you’re a heavy drinker. Go to your doctor if you develop any of these symptoms:
These symptoms can be caused by many things, but it’s best to speak to your doctor for a referral to a specialist to check what is causing your symptoms.
If you’re worried or would like more information about the risks of cancer, speak to your specialist or your doctor.
Chronic pancreatitis won’t go away – it can’t be cured but it can be treated. Some people who stop smoking and drinking alcohol may find this also helps to manage their symptoms.
Once your pancreas is damaged, that damage can’t be reversed and your pancreas won’t work properly again. Inflammation gradually damages your pancreas and causes scar tissue to build up. This affects how well your pancreas works and, over time, it gradually stops making digestive enzymes and insulin. This is why it's important to get the right treatment as quickly as possible to prevent complications.
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