Pancreatitis
Inflammation of the pancreas — from a sudden, painful attack to a long-standing condition needing specialist care.
Pancreatitis is inflammation of the pancreas, the organ that makes digestive enzymes and insulin. It causes severe upper-abdominal pain, nausea and vomiting. The commonest causes are gallstones and alcohol. Mild attacks settle with rest, fluids and pain relief, while gallstone pancreatitis often needs gallbladder surgery to prevent it returning.
The pancreas plays a vital role in digestion and blood-sugar control, so when it becomes inflamed the effects can be dramatic and, at times, dangerous. Pancreatitis ranges from a mild attack that settles in a few days to a severe, life-threatening illness. Because gallstones are a leading cause, treatment often involves close teamwork between a GI surgeon and other specialists.
प्यान्क्रियाटाइटिस भनेको प्यान्क्रियाज (अग्न्याशय) सुनिने अवस्था हो, जसले पेटको माथिल्लो भागमा तीव्र दुखाइ गराउँछ — यसको प्रमुख कारण पित्तथैलीको ढुंगा र रक्सी हो।
Understanding Pancreatitis
The pancreas is a long gland lying behind the stomach. It produces enzymes that digest food in the intestine and hormones such as insulin that control blood sugar. In pancreatitis these powerful digestive enzymes become activated too early, inside the pancreas itself, and begin to irritate and damage the gland — in effect, the organ starts to digest its own tissue.
There are two main forms. Acute pancreatitis comes on suddenly and, in most people, settles with treatment. Chronic pancreatitis is long-standing inflammation that gradually scars the gland, leading to persistent pain and problems with digestion and blood sugar.
Symptoms
- Severe pain in the upper abdomen, often spreading to the back
- Pain that may worsen after eating, especially fatty meals
- Nausea and vomiting
- A tender, bloated abdomen
- Fever and a rapid pulse
- In chronic cases: weight loss, greasy or foul-smelling stools and new diabetes
Causes & risk factors
- Gallstones blocking the pancreatic duct
- Heavy or long-term alcohol use
- High levels of triglycerides (fats) in the blood
- Certain medicines
- Abdominal injury or complications after some procedures (such as ERCP)
- High blood calcium or, occasionally, an inherited tendency
Possible complications
- Pancreatic pseudocysts — fluid collections that may need drainage
- Infection or death of pancreatic tissue (necrosis)
- Severe illness affecting the lungs, kidneys and circulation
- Diabetes from damage to insulin-producing cells
- Poor digestion and malnutrition in chronic pancreatitis
How it is diagnosed
Pancreatitis is diagnosed from the typical pain together with blood tests showing raised pancreatic enzymes (amylase and lipase). Imaging such as ultrasound, CT or MRI/MRCP identifies the cause — for example gallstones — and assesses the severity and any complications. These tests guide whether treatment can be simple and supportive or needs to be more intensive.
Treatment options
Most attacks of acute pancreatitis are treated in hospital with rest for the pancreas, intravenous fluids, pain relief and careful monitoring, with eating reintroduced as symptoms improve. Treating the underlying cause is essential — avoiding alcohol, controlling blood fats, or clearing a blocked bile duct. Severe pancreatitis needs specialist, sometimes intensive, care to manage complications.
Surgical treatment
Surgery is directed at the cause and complications rather than the inflammation itself. When gallstones are responsible, Dr. Sujan Shrestha performs laparoscopic cholecystectomy (keyhole gallbladder removal), usually once the attack has settled, to prevent pancreatitis returning. Complications such as infected pancreatic tissue or large pseudocysts may need drainage or specialised hepatopancreatobiliary (HPB) surgery, which Dr. Shrestha undertakes as part of his advanced GI practice.
Recovery & aftercare
Recovery from a mild acute attack usually takes a few days to a couple of weeks, after which normal eating resumes and the cause is treated. Severe pancreatitis can require a much longer hospital stay and gradual rehabilitation. In chronic pancreatitis, ongoing care focuses on pain control, enzyme and dietary support, and strict avoidance of alcohol to protect the remaining pancreas.
When to see a doctor
Seek urgent medical care for severe, persistent upper-abdominal pain, especially with vomiting, fever, or a rapid heartbeat. Pancreatitis can worsen quickly and needs hospital assessment. Anyone who has had gallstone pancreatitis should discuss timely gallbladder surgery to prevent a further, potentially more serious attack.
Frequently asked questions
Gallstones and heavy alcohol use are the two leading causes. Gallstone pancreatitis happens when a stone blocks the duct that drains the pancreas, and it is often prevented from returning by removing the gallbladder.
Most acute attacks are mild and settle with hospital treatment. However, a minority become severe and life-threatening, which is why prompt assessment and monitoring are important.
If gallstones caused the attack, they are likely to trigger another, potentially worse one. Removing the gallbladder by keyhole surgery, usually after the inflammation settles, greatly reduces that risk.
Yes, especially if the underlying cause is not treated. Repeated attacks can lead to chronic pancreatitis and permanent damage, so addressing gallstones, alcohol or high blood fats is essential.
Avoiding alcohol, eating a balanced low-fat diet, controlling blood fats and treating gallstones all help. If you have had pancreatitis, your doctor will advise on the specific steps for your situation.
Get a clear answer from a specialist
Dr. Sujan Shrestha (MBBS, MS, MCh) offers evidence-based, minimally invasive care for pancreatitis and the full range of GI conditions.