What Is Pancreatitis?
Pancreatitis is inflammation of the pancreas. The pancreas produces digestive enzymes and insulin. When inflamed, digestive enzymes activate inside the pancreas and begin digesting the organ itself. It can be mild (oedematous) or severe and life-threatening (necrotising).
Symptoms
- Severe upper abdominal pain that radiates to the back — 'boring through' character
- Nausea and vomiting
- Fever and rapid pulse
- Abdominal tenderness and guarding
- In severe cases: jaundice, Grey Turner's sign (flank bruising), Cullen's sign (periumbilical bruising)
Diagnostic Blood Tests
| Test | Finding in Pancreatitis |
|---|---|
| Serum Lipase | Elevated >3× upper limit of normal — more specific than amylase |
| Serum Amylase | Elevated >3× normal — rises quickly but normalises faster than lipase |
| Full Blood Count | Raised WBC indicates infection |
| Liver function tests | Elevated ALP/bilirubin if gallstone cause |
| Calcium | Low calcium is a poor prognostic sign |
| Glucose | Elevated — pancreatic function impairment |
| CRP | High CRP (>150 mg/L at 48h) predicts severe disease |
Common Causes
- Gallstones (most common — UK/US)
- Alcohol (heavy use — second most common)
- Hypertriglyceridaemia (very high triglycerides)
- Medications (steroids, azathioprine, some diuretics)
- ERCP procedure complication
- Trauma
FAQs
Can pancreatitis become chronic?
Yes — repeated episodes (especially alcohol-related) cause permanent damage, leading to chronic pancreatitis with pain, malabsorption and diabetes.
Is fasting required during treatment?
Mild pancreatitis: early oral feeding is now encouraged. Severe cases may require IV nutrition.
Can pancreatitis be fatal?
Severe necrotising pancreatitis has mortality up to 30%. Most acute episodes are mild and resolve with fluids and pain management.
Medical Disclaimer: Severe abdominal pain suspected to be pancreatitis requires urgent hospital assessment and cannot be managed at home.