Acute Pancreatitis

Condition Basics

What is acute pancreatitis?

The pancreas is an organ behind the stomach. It makes hormones like insulin that help control how your body uses sugar. It also makes enzymes that help you digest food.

Usually these enzymes flow from the pancreas to the intestines. But if they leak into the pancreas, they can irritate it and cause pain and swelling. When this happens suddenly, it's called acute pancreatitis.

What causes it?

Most of the time, acute pancreatitis is caused by gallstones or by alcohol use. Gallstones can block the flow of enzymes from the pancreas into the intestines. Alcohol can injure the pancreas. The amount of alcohol needed to cause this type of pancreatitis may be different for each person. It may happen after a drinking binge. Or it may happen after many episodes of heavy drinking.

Other causes of acute pancreatitis may include:

• Infections, including mumps.
• Some medicines. These include certain antibiotics, steroids, and blood pressure medicines.
• Injury, such as trauma to the belly.
• Very high fat level (triglycerides) in the blood.

Sometimes the cause isn't known.

What are the symptoms?

The main symptom of acute pancreatitis is mild to severe pain in the upper part of the belly (abdomen). Pain may also spread to your back. Symptoms often come or get worse after you eat.

Sometimes the pain is mild. But the pain may feel like it goes through the belly to the back. Sitting up or leaning forward sometimes eases the pain. Other symptoms of an attack of pancreatitis may include:

• Nausea and vomiting.
• A fever.
• A fast heart rate.
• Sweating.
• Shock. This may include fatigue, confusion, or feeling lightheaded or dizzy.

How is it diagnosed?

Your doctor will diagnose pancreatitis with an exam and by looking at your lab tests. Your doctor may think that you have this problem based on your symptoms and where in your belly you have pain.

You may have blood tests of enzymes called amylase and lipase. In pancreatitis, the level of these enzymes is usually much higher than normal.

You also may have imaging tests of the belly. These may include an ultrasound, a CT scan, or an MRI. A special MRI called MRCP can show images of the bile ducts. This test can be very helpful when gallstones are causing the problem.

How is it treated?

Most attacks of acute pancreatitis need treatment in the hospital. Your doctor will give you pain medicine and fluids through a vein (I.V.). You'll get these until the pain goes away.

Based on what caused the pancreatitis, you may need to stop drinking alcohol. And you may need to make changes to your diet, like eating low-fat foods. Changes like these help lower your risk for future attacks.

If gallstones are causing pancreatitis, you may need endoscopic retrograde cholangiopancreatogram (ERCP). It's a procedure to remove the stones if they don't pass on their own. You may need surgery to remove your gallbladder.

Most people get well after an attack of pancreatitis. But problems can happen. Problems may include cysts and infection. Or some of the tissue in the pancreas might die. Surgery may be done to remove a part of the pancreas that has been damaged. This surgery isn't common.