Symptoms
- Severe, constant pain in the upper belly, often boring through to the back
- Nausea and vomiting
- Pain often worse after food, a little better leaning forward
Severe upper-belly pain going to the back, with vomiting, needs a hospital the same day. Don't keep taking painkillers at home.
Common causes
- Gallstones, the leading cause in many people
- Alcohol
- Very high triglycerides (blood fats)
- Some medicines, after ERCP, injury, genetics, and sometimes no clear cause ("idiopathic")
What happens in hospital
Treatment is supportive: fluids through a drip, pain relief, and early feeding by mouth as soon as you can manage it. Most people improve within days. Antibiotics are only needed for a proven infection. A CT scan is not always needed early; it's used if things aren't improving.
If a stone is stuck in the bile duct with jaundice or infection, an early ERCP may be needed.
Complications
In a minority, part of the pancreas dies (necrosis) or fluid collects around it. Many of these settle on their own. If they become infected or cause symptoms after about 4 weeks, they can usually be drained endoscopically. See pseudocysts and walled-off necrosis.
Preventing the next attack
- Gallstone pancreatitis: gallbladder removal, usually during the same admission or soon after
- Alcohol: stopping completely; there's no safe "occasional" drink after alcohol-related pancreatitis
- High triglycerides: diet, medicines and diabetes control
- Unexplained or repeated attacks: EUS to look for small stones and other hidden causes
Common questions
Does only alcohol cause pancreatitis?
No. Gallstones are equally important, and many people with pancreatitis don't drink at all.
Can I drink occasionally after pancreatitis?
After alcohol-related pancreatitis, any alcohol risks another attack and chronic pancreatitis. Stopping completely is part of the treatment.