Pancreatitis

Inflammation of the pancreas. Acute pancreatitis can be life-threatening within hours, and the pain has a distinctive shape.

What it is

Acute pancreatitis is sudden inflammation of the pancreas. Around 30,000 people are admitted with it each year in the UK.

Two causes account for most cases: gallstones blocking the pancreatic duct, and alcohol. Together they explain around 80%.

Most cases are mild and settle with fluids and pain relief over days. Around a fifth become severe, with organ failure and a significant mortality.

Chronic pancreatitis is different: repeated or ongoing inflammation destroys the gland, causing constant pain, an inability to digest fat, and eventually diabetes. It is most often caused by long-term alcohol use.

Signs you might notice

Severe pain in the upper abdomen, coming on over hours, boring straight through to the back.

Pain often eased by sitting forward and worsened by lying flat, which is characteristic.

Vomiting that does not relieve the pain.

Fever, a fast pulse, and feeling very unwell.

In severe cases: breathlessness, confusion, and shock.

In chronic pancreatitis: recurring pain, greasy pale stools that float and are hard to flush, weight loss, and diabetes.

How it can affect day-to-day life

Delay is the risk. Severe pancreatitis needs aggressive fluid resuscitation early, and the outcome depends substantially on the first 24 hours.

In chronic pancreatitis, pancreatic enzyme replacement therapy is the treatment for malabsorption, and it is significantly under-prescribed and under-dosed. People lose weight and become malnourished while nobody addresses digestion.

Alcohol is often the cause and often not discussed properly, which leaves the underlying problem untreated. See alcohol dependence.

Supporting someone well

Get severe upper abdominal pain radiating to the back assessed urgently. Do not wait it out.

Stop alcohol completely after an episode. Continuing is the single strongest predictor of recurrence and of progression to chronic pancreatitis.

In chronic pancreatitis, ask about pancreatic enzyme replacement and about the dose. Under-dosing is the norm and the signs are floating stools and weight loss.

Ask about fat-soluble vitamin levels and bone density, both commonly affected.

Have gallstones dealt with after a gallstone-related episode rather than waiting for the next one.

Take the pain seriously; chronic pancreatitis pain is severe and frequently under-treated.

Where to get help

Severe abdominal pain with vomiting needs 999 or urgent assessment.

Guts UK have specific information on pancreatitis, and Pancreatitis Supporters Network provide peer support.

Ask for referral to a specialist pancreatic service for chronic pancreatitis.