Word on Health

Word on Pancreatitis

Our grateful thanks to the charity GUTS UK and their spokesperson Julie Thompson for their input to our radio report (which you can hear again via the audio player at the bottom of this page) and to the NHS for the use of the information below.

Acute pancreatitis is a condition where the pancreas becomes inflamed (swollen) over a short period of time.

The pancreas is a small organ, located behind the stomach, that helps with digestion.

Most people with acute pancreatitis start to feel better within about a week and have no further problems. But some people with severe acute pancreatitis can go on to develop serious complications.

Acute pancreatitis is different to chronic pancreatitis, where the pancreas has become permanently damaged from inflammation over many years.

The most common symptoms of acute pancreatitis include:

  • suddenly getting severe pain in the centre of your tummy (abdomen)
  • feeling or being sick
  • a high temperature of 38C or more (fever)
  • Read more about the symptoms of acute pancreatitis and diagnosing acute pancreatitis.

When to get medical help. See a GP immediately if you suddenly develop severe abdominal pain. If this isn't possible, contact NHS 111 for advice.

Causes of acute pancreatitis. Acute pancreatitis is most often linked to:

  • Gallstones - small stones that form in your gallbladder. They can sometimes trigger acute pancreatitis if they move out of the gallbladder and block the opening of the pancreas.

  • Alcohol consumption - It's not fully understood how alcohol causes the pancreas to become swollen (inflamed). One theory is that it causes enzymes inside the pancreas to start digesting it.

Whatever the cause, there is a clear link between alcohol use and acute pancreatitis.

Binge drinking – drinking a lot of alcohol in a short period of time – is also thought to increase your risk of developing acute pancreatitis.

Other causes. Less common causes of acute pancreatitis include:

  • high blood fat levels (hypertriglyceridaemia)
  • accidental damage or injury to the pancreas – for example, during a procedure to remove gallstones or examine the pancreas
  • a side effect of medicine
  • viruses like mumps or measles
  • high blood calcium levels (hypercalcaemia)
  • the immune system attacking the pancreas (autoimmune pancreatitis)

Severe pancreatitis. You're probably more likely to develop severe pancreatitis if you:

  • are over 70
  • are obese (you have a body mass index (BMI) of 30 or above)
  • have 2 or more alcoholic drinks a day
  • smoke
  • have a family history of pancreatitis

By reducing how much alcohol you drink and altering your diet to make gallstones less likely, you can reduce your chances of developing acute pancreatitis.

How it's treated. Treatment for acute pancreatitis aims to help control the condition and manage any symptoms.

This usually involves admission to hospital. You may be given fluids directly into a vein (intravenous fluids), pain relief, liquid food through a tube in your tummy and oxygen through tubes in your nose.

Most people with acute pancreatitis get better within a week and are well enough to leave hospital after a few days.

Recovery can take longer in severe cases, as some people can develop complications.

Most people with acute pancreatitis recover without experiencing any further problems. But those with severe acute pancreatitis can develop serious complications such as; 

  • Pseudocysts - Sometimes, sacs of fluid, called pseudocysts, can develop on the surface of the pancreas in people with acute pancreatitis. These can cause bloating, indigestion and dull tummy pain. They often disappear on their own but can sometimes get infected and may need to be drained.

  • Pancreatic necrosis and infection -Sometimes people with severe acute pancreatitis can develop a complication where the pancreas loses its blood supply. This can cause some of the tissue of the pancreas to die (necrosis). When this happens, the pancreas can become infected, which can spread into the blood (sepsis) and cause organ failure. People with necrosis and an infection may need injections of antibiotics and surgery to remove the dead tissue. This is a very serious complication that needs treating, and it can be fatal.

Chronic pancreatitis, If you keep getting acute pancreatitis, it may eventually permanently damage your pancreas.

This is called chronic pancreatitis and is a long-term condition that can seriously affect your quality of life.

Chronic pancreatitis is a condition where the pancreas has become permanently damaged from inflammation and stops working properly.

Chronic pancreatitis can affect people of any age. It is more common in men.

It's different from acute pancreatitis, where the inflammation is only short term.

Most people with chronic pancreatitis have had 1 or more attacks of acute pancreatitis.

Symptoms of chronic pancreatitis. The most common symptom of chronic pancreatitis is repeated episodes of severe pain in your tummy (abdomen). The pain usually develops in the middle or left side of your tummy and can move along your back.

It's been described as a burning or shooting pain that comes and goes, but may last for several hours or days.

Although the pain sometimes comes on after eating a meal, there's often no trigger. Some people might feel sick and vomit.

As the condition progresses, the painful episodes may become more frequent and severe.

Eventually, a constant dull pain can develop in your tummy, between episodes of severe pain.

This is most common in people who continue to drink alcohol after being diagnosed with chronic pancreatitis.

Some people who stop drinking alcohol and stop smoking may find the pain is less severe.

Advanced chronic pancreatitis. Other symptoms develop as the damage to the pancreas progresses and it becomes unable to produce digestive juices, which help to break down food.

The absence of digestive juices means it's harder to break down fats and some proteins. This can cause your poo to become very smelly and greasy, and make it difficult to flush down the toilet.

The pancreas usually only loses these functions many years after the first symptoms started. You may also experience:

  • weight loss
  • loss of appetite
  • yellowing of the skin and eyes (jaundice)
  • symptoms of diabetes – such as feeling very thirsty, needing to pee more often than usual and feeling very tired
  • ongoing nausea and sickness (vomiting)

When to get medical advice. See a GP immediately if you're experiencing severe pain, as this is a warning sign that something is wrong. If this is not possible, contact NHS 111 for advice.

You should also see a GP as soon as you can if:

  • your skin or the whites of your eyes turn yellow (jaundice)
  • you keep being sick
  • Jaundice can have a range of causes other than pancreatitis, but it's usually a sign there's something wrong with your digestive system.

Diagnosing chronic pancreatitis. A GP will ask about your symptoms and may examine you. They'll refer you to a specialist for further tests if they think you have chronic pancreatitis. The specialist will be able to confirm whether you have the condition.

Tests. Tests and scans are usually carried out in your local hospital.

They may include:

  • an ultrasound scan – where sound waves are used to create a picture of your pancreas
  • a CT scan – where a series of X-rays are taken to build up a more detailed 3D image of your pancreas
  • an endoscopic ultrasound scan – where a long, thin tube containing a camera is passed through your mouth and down into your stomach to take pictures of your pancreas
  • magnetic resonance cholangiopancreatography (MRCP) – a type of MRI scan that takes a detailed image of your pancreas and the organs around it
  • Biopsy

Sometimes the symptoms of chronic pancreatitis can be very similar to pancreatic cancer.

You may need a biopsy, where a small sample of cells is taken from the pancreas and sent to a laboratory to be checked, to rule this out.

Causes of chronic pancreatitis

The most common cause of chronic pancreatitis is drinking excessive amounts of alcohol over many years.

This can cause repeated episodes of acute pancreatitis, which results in increasing damage to the organ.

In children the most common cause is cystic fibrosis.

Less common causes include:

  • smoking
  • the immune system attacking the pancreas (autoimmune chronic pancreatitis)
  • inheriting a faulty gene that stops the pancreas working properly
  • injury to the pancreas
  • gallstones blocking the openings (ducts) of the pancreas
  • radiotherapy to the tummy

In some cases, no cause can be identified. This is called idiopathic chronic pancreatitis.

Treatment for chronic pancreatitis. The damage to the pancreas is permanent, but treatment can help control the condition and manage any symptoms.

People with chronic pancreatitis are usually advised to make lifestyle changes, such as stopping drinking alcohol and stopping smoking. They're also given medicine to relieve pain.

Surgery may also be an option for those experiencing severe pain.

Complications

Living with chronic pain can cause mental as well as physical strain.

See a GP if you're experiencing stress, anxiety or depression caused by chronic pancreatitis.

Some people with chronic pancreatitis will eventually develop a type of diabetes known as type 3c diabetes.

This occurs when the pancreas can no longer produce insulin because it's become so damaged.

People with chronic pancreatitis can sometimes develop sacs of fluid on the surface of their pancreas (pseudocysts). These can cause bloating, indigestion and dull tummy pain.

These cysts often disappear on their own. But sometimes they need to be drained using a technique called endoscopic ultrasound drainage, or endoscopic transpapillary drainage.

Chronic pancreatitis increases your risk of pancreatic cancer, although the chance is still small.

Support for people living with chronic pancreatitis

Any long-term health condition, particularly one that causes recurring episodes of pain or constant pain, can affect your emotional and psychological health.

See a GP if you're experiencing psychological and emotional difficulties. There are medicines available that can help with stress, anxiety and depression.

Talking to other people with the same condition can often reduce feelings of isolation and stress. GUTS UK offers help and support for people living with chronic pancreatitis.

Listen to this weeks radio report

All material on this website is provided for your information only and may not be construed as medical advice or instruction. No action or inaction should be taken based solely on the contents of this information; instead, readers should consult appropriate health professionals on any matter relating to their health and well-being.