Pancreatitis refers to inflammation of the pancreas, which can cause pain and swelling in the upper abdomen. The pain can be severe and often resembles a burning sensation. Other common symptoms include nausea and vomiting.
The pancreas is located in the upper abdomen, where it lies behind the stomach. This organ is key to digestive processes, producing both digestive juices and digestive hormones. The digestive juices contain enzymes and bicarbonate. The enzymes break down proteins and fats present in food, so that nutrients can be absorbed and the bicarbonate neutralizes acid present in the stomach. The two main digestive hormones are insulin and glucagon, which get released into the bloodstream to help control the level of blood sugar circulating in the body.
When the pancreas is inflamed, the gland itself and the blood vessels surrounding it begin to swell, which can lead to bleeding, infection and pancreatic damage. Obstruction in the pancreas may cause digestive juices to become trapped inside where they start to “digest” the organ itself. Ongoing damage can eventually lead to a loss of pancreatic function.
Pancreatitis can occur in two forms. In the acute form of the illness, the pancreas is temporarily inflamed and the condition usually improves within a few days. In the chronic form of pancreatitis, the inflammation persists and causes an increasing amount of damage. Chronic pancreatitis may develop after repeated occurrences of acute pancreatitis. Either form of pancreatitis can cause severe symptoms and life-threatening complications.
Acute pancreatitis is less common than chronic pancreatitis, although incidence has risen slightly over the last four decades, possibly owing to an overall increase in alcohol consumption and particularly binge drinking. Aside from alcohol, gallstones are another main cause of the condition. The average age that patients develop acute pancreatitis symptoms due to alcohol consumption is 38, while for acute pancreatitis related to gallstones, the average age at symptom onset is 69.
The main symptom of acute pancreatitis is abdominal pain, that usually occurs just below the ribs. The pain may build up quickly and become severe or it may occur as mild pain initially and then slowly worsen. Typically, the pain radiates across the back and is aggravated by eating. On rare occasions, no pain occurs, but this is more likely in cases of diabetes or kidney disease. Other common symptoms include:
- A general feeling of malaise
- Swollen abdomen
If the pancreatitis becomes severe and starts to involve other organs such as the kidneys or heart, then various additional symptoms can develop such as dehydration or hypotension (low blood pressure).
Chronic pancreatitis refers to the ongoing inflammation that causes scarring and damage to the pancreas. Persistent damage and scarring is eventually followed by deposits of calcium building up and forming pancreatic stones. The scarring and/or stones in the ducts of the pancreas can cause the ducts to block, which disrupts the flow of digestive juices. The damaged pancreas also fails to produce digestive hormones. Nutrients therefore fail to be properly absorbed and a lack of insulin production leads to diabetes. These digestive problems and diabetes may take many years to develop, with the inflammation process persisting for a very long time before any symptoms actually become apparent.
Chronic pancreatitis often develops after a series of alcohol-related acute pancreatitis episodes. When the patient continues to drink after these events, the condition eventually becomes chronic. The symptoms of chronic pancreatitis are described in more detail below.
Abdominal pain occurs below the ribs and tends to be persistent, although it may be relieved by curling the body into a ball shape. If the pancreatitis is caused by gallstones, the pain often develops after a large meal has been eaten. Around one fifth of patients with chronic pancreatitis do not experience any pain.
Weight loss and pale stools may occur as a result of poor digestion. A lack of digestive enzymes affects the digestion of fats and certain vitamins. Undigested fat remaining in the gut eventually gets passed with the stool, which makes the stool loose, smelly and pale. Poor absorption of fat and nutrients can also lead to weight loss.