Pancreatitis is inflammation of the pancreas, the gland behind the stomach that makes digestive enzymes and insulin. Acute pancreatitis comes on suddenly when enzymes activate inside the gland and begin to digest it. Chronic pancreatitis is long-standing inflammation that scars the gland permanently.
About four in five acute attacks are mild and settle within a week in hospital. Severe attacks can cause organ failure and need intensive care. Chronic pancreatitis cannot be reversed, so treatment aims at pain control, replacing enzymes and insulin, and stopping the cause.
Symptoms
- Severe, constant upper abdominal pain that often bores through to the back
- Pain eased slightly by sitting forward and worse lying flat
- Nausea and repeated vomiting
- Fever and a fast pulse
- A tender, swollen abdomen
- In chronic disease: recurring pain after meals, pale greasy floating stools and weight loss
- New diabetes in long-standing chronic pancreatitis
Causes and risk factors
Gallstones and alcohol together cause about seven in ten acute cases. A small stone passing down the bile duct blocks the pancreatic outlet. Other causes are very high triglycerides, high calcium, medicines such as azathioprine, valproate and some diuretics, ERCP procedures, abdominal injury, autoimmune pancreatitis, viral infections, and tumours obstructing the duct. Chronic pancreatitis is mostly due to sustained heavy drinking and smoking, with genetic mutations, including those of cystic fibrosis, autoimmune disease and duct obstruction as other causes. In some people no cause is found.
How it is diagnosed
- Blood lipase or amylase: A level more than three times the upper limit with typical pain confirms acute pancreatitis. Liver tests, triglycerides, calcium and CRP help find the cause and gauge severity.
- Abdominal ultrasound: Done in every first attack to look for gallstones.
- Contrast CT scan: Not needed at once in clear cases. Done after 3 to 5 days if the person is not improving, to look for dead tissue and fluid collections.
- MRCP and endoscopic ultrasound: Detect small duct stones, duct abnormalities, early chronic changes and small tumours. Important after an unexplained attack, especially over the age of 40.
- Faecal elastase: A stool test of enzyme output to diagnose pancreatic insufficiency in chronic disease.
- IgG4 and genetic tests: For suspected autoimmune or hereditary pancreatitis.
Treatment options
- Hospital supportive care: Intravenous fluids, strong pain relief, oxygen and early feeding by mouth or tube as soon as tolerated. Antibiotics only for proven infection.
- Removing the cause: Gallbladder removal, ideally during the same admission for mild gallstone pancreatitis. Urgent ERCP if the bile duct is blocked and infected. Complete abstinence from alcohol, and lowering triglycerides.
- Drainage of collections: Endoscopic drainage through the stomach wall, or minimally invasive removal of infected dead tissue, usually delayed for about 4 weeks until it has walled off.
- Pancreatic enzyme capsules: Taken with every meal and snack in chronic pancreatitis to correct greasy stools and weight loss, with vitamin D and other fat-soluble vitamins.
- Pain management in chronic disease: Stopping alcohol and smoking, stepped pain relief, endoscopic stone removal or stenting, nerve blocks, and surgery such as duct drainage or partial resection for selected patients.
- Diabetes care: Insulin is often needed, with attention to the risk of low blood sugar.
When it is urgent
Severe upper abdominal pain that lasts more than a few hours, particularly with vomiting, fever, yellow skin, breathlessness or faintness, needs the nearest emergency department. Acute pancreatitis is treated in hospital where you are and is never a condition to travel with.
Travelling to Türkiye for treatment
After recovery, travel can be reasonable for defined goals: finding the cause of unexplained or recurrent attacks with MRCP and endoscopic ultrasound, planned gallbladder removal, or assessment of chronic pancreatitis for endoscopic or surgical treatment. Allow time for recovery before flying, carry enzyme capsules and a medical summary, and do not travel within a few weeks of a severe attack without your doctor's agreement.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
Frequently Asked Questions
Can I ever drink alcohol again?
If alcohol caused the attack, the advice is lifelong abstinence. After gallstone pancreatitis, avoid alcohol for some months and then keep it modest. Continued drinking is the main driver of repeated attacks and chronic disease.
Will pancreatitis come back?
It can if the cause stays. Removing the gallbladder after gallstone pancreatitis, stopping alcohol and smoking, and controlling triglycerides greatly reduce recurrence.
Does pancreatitis lead to cancer?
Chronic pancreatitis raises the lifetime risk of pancreatic cancer somewhat, and hereditary forms more so. An unexplained first attack after the age of 40 should prompt imaging to exclude a small tumour.
What diet should I follow?
Small regular meals with normal, not extreme, fat restriction, enough protein, and enzyme capsules if prescribed. Very low-fat diets are no longer advised because they worsen malnutrition.