Acute Pancreatitis

What Causes Acute Pancreatitis (AP)?

• Gallstones — The most common cause. A stone can block the duct that drains the pancreas.
• Heavy alcohol use — Heavy alcohol use can cause acute pancreatitis.
• High triglyceride levels (hypertriglyceridemia) – Very high levels of triglycerides (a type of fat) in the blood can cause pancreatic inflammation.
• Medications and other causes – Certain medications can trigger pancreatitis. Other causes include autoimmune pancreatitis, genetic or inherited risk factors, procedures such as ERCP, infections, and abdominal injury.
• Sometimes, no cause is found. This is called idiopathic acute pancreatitis.

Common Symptoms:

• Severe or persistent pain in the upper abdomen that may spread to your back
• Nausea and vomiting
• Swollen, tender belly
• Fever or a fast heartbeat

Seek medical care right away

Severe or constant belly pain — especially with vomiting or fever — needs urgent medical evaluation.

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Acute pancreatitis is usually diagnosed based on your symptoms and blood tests, especially a pancreatic enzyme called lipase. Imaging may be needed in some cases to confirm the diagnosis or look for a cause or complications.

• Abdominal ultrasound — checks for gallstones
• CT scan - may be used when the diagnosis is unclear, symptoms are severe, or you are not improving as expected. It can also identify complications such as fluid collections or damaged pancreatic tissue.
• MRI/MRCP — a detailed scan that looks at the pancreas, gallbladder, and ducts that carry digestive fluids.

Treatment depends on what caused the pancreatitis. If gallstones are the cause, gallbladder removal is usually recommended to help prevent another episode. ERCP may be needed in certain situations, such as when a stone remains in the bile duct. Other causes, such as very high triglycerides, are treated medically.

• IV Fluids — Fluids may be given through a vein to treat or prevent dehydration, particularly early in the illness.  
• Nutrition — Eating is encouraged as soon as you tolerate food. If you cannot eat enough by mouth, nutrition may be given through a feeding tube.
• Pain and Nausea Control — Medicines are given as needed to control pain and nausea.  

Most people with acute pancreatitis recover well. Recovery time can vary depending on how severe the pancreatitis is and what caused it.

• Recovery takes time — You may continue to feel tired or have some abdominal discomfort for days or weeks after an episode. Follow your healthcare team’s instructions about returning to normal activities and eating.  
• Follow-up is important — Your healthcare provider may recommend follow-up visits to make sure you are recovering and to address the cause of your pancreatitis.
• Eating after pancreatitis — Most people can gradually return to their usual diet as they recover. You generally do not need to avoid all fat unless your healthcare team recommends it for a specific reason.  
• Preventing another episode — Treating the cause of pancreatitis can help lower the risk of having another episode. If you have ongoing or new symptoms, such as worsening abdominal pain, vomiting, fever, yellowing of the skin or eyes, or difficulty eating or drinking, contact your healthcare provider.