What Is Pancreatitis?

Pancreatitis is inflammation of the pancreas, a gland behind your stomach that produces digestive enzymes and hormones (like insulin) to regulate blood sugar. When these enzymes activate too early inside the pancreas, they begin to "digest" the pancreas itself, leading to pain, swelling and, in severe cases, life-threatening complications.

Pancreatitis occurs in two main forms:

• Acute pancreatitis
  Sudden inflammation that may be mild or life-threatening but usually resolves within days to weeks with proper treatment.
• Chronic pancreatitis
  Long-standing inflammation that leads to irreversible damage, fibrosis (scarring) and loss of function over time.

Both forms share similar causes and symptoms, but chronic pancreatitis can lead to ongoing digestive problems, diabetes and a higher risk of complications.

Acute Pancreatitis

Pathophysiology & Classification

According to the revised Atlanta classification (Banks et al., 2013), acute pancreatitis is categorized by severity:

1. Mild
   No organ failure, no local or systemic complications.
2. Moderately Severe
   Transient organ failure (resolves within 48 hours) or local complications (e.g., fluid collections).
3. Severe
   Persistent organ failure (> 48 hours), which may involve the lungs, kidneys or cardiovascular system.

Common Causes

Most cases of acute pancreatitis are triggered by:

• Gallstones (block the pancreatic duct)
• Heavy alcohol use
• High blood triglycerides (hypertriglyceridemia)
• Certain medications (e.g., some diuretics, immunosuppressants)
• Trauma or surgical procedures near the pancreas
• Autoimmune disorders
• Genetic mutations (e.g., CFTR, PRSS1)
• Infections (rare)

Signs & Symptoms

Symptoms often develop suddenly and can range from mild discomfort to intense pain:

• Severe, constant upper abdominal pain, often radiating to the back
• Nausea and vomiting
• Abdominal tenderness and swelling
• Fever, rapid heart rate
• Jaundice (if a gallstone blocks the bile duct)

Diagnosis

Diagnosis combines clinical evaluation, blood tests and imaging:

• Blood tests: elevated pancreatic enzymes (amylase, lipase)
• Liver function tests (to check for gallstone obstruction)
• Abdominal ultrasound: first-line to detect gallstones and ductal dilation
• Contrast-enhanced CT scan: assesses severity, detects complications (necrosis, fluid collections)
• MRCP or endoscopic ultrasound: detailed images of ducts, stones

Treatment

There is no specific "cure" for acute pancreatitis; management is supportive:

• Hospital admission for close monitoring
• Aggressive IV fluids to maintain blood pressure and circulation
• Pain control (usually with opioid or non-opioid analgesics)
• Nutritional support
  • Mild cases: clear liquids advancing to a low-fat diet as tolerated
  • Severe cases: enteral feeding (tube) if oral intake is not possible
• Treat underlying cause
  • Gallstones: may require endoscopic retrograde cholangiopancreatography (ERCP) or surgery
  • High triglycerides: lipid-lowering therapy
  • Medications: adjust or discontinue potential triggers
• Monitor for complications
  • Infected necrosis (may need antibiotics or drainage)
  • Organ failure (intensive care support)

Most people with mild acute pancreatitis recover fully in 3–7 days. Moderately severe and severe cases may take weeks to months, especially if complications arise.