Acute Pancreatitis

Acute Pancreatitis

Acute pancreatitis means inflammation of the pancreas that develops quickly. The main symptom is tummy (abdominal) pain. It usually settles in a few days but sometimes it becomes severe and very serious. The most common causes of acute pancreatitis are gallstones and drinking a lot of alcohol.

What is the pancreas?

The pancreas is in the upper tummy (abdomen) and lies behind the stomach and guts (intestines). It makes a fluid that contains chemicals (enzymes) which are needed to digest food. The enzymes are made in the pancreatic cells and are passed into tiny tubes (ducts). These ducts join together like branches of a tree to form the main pancreatic duct. This drains the enzyme-rich fluid into the part of the gut just after the stomach (called the duodenum). The enzymes are in an inactive form in the pancreas (otherwise they would digest the pancreas). They are 'activated' in the duodenum to digest food.

Groups of special cells called 'islets of Langerhans' are scattered throughout the pancreas. These cells make the hormones insulin and glucagon. The hormones are passed (secreted) directly into the bloodstream to control the blood sugar level.

The bile duct carries bile from the liver and gallbladder. This joins the pancreatic duct just before it opens into the duodenum. Bile also passes into the duodenum and helps to digest food.

Diagram showing the liver

Diagram showing detail around the pancreas

What is pancreatitis?

Pancreatitis means inflammation of the pancreas. There are two types:

Acute pancreatitis - the inflammation develops quickly, over a few days or so. It often goes away completely and leaves no permanent damage. Sometimes it is serious.

Chronic pancreatitis - the inflammation is persistent. The inflammation tends to be less intense than acute pancreatitis but as it is ongoing it can cause scarring and damage. Chronic pancreatitis is not dealt with further in this leaflet.

Acute pancreatitis has become more common in recent years. One of the reasons for this is that there has been an increase in alcohol consumption recently - in particular, binge drinking.

Causes of acute pancreatitis

Gallstones or alcohol cause more than 8 in 10 cases. Other causes are rare.

Gallstones . A gallstone can pass through the bile duct and out into part of the gut just after the stomach (the duodenum). This usually does not cause a problem. However, in some people a gallstone becomes stuck in the bile duct or where the bile duct and pancreatic duct open into the duodenum. This can affect the chemicals (enzymes) in the pancreatic duct (or even block them completely) and trigger a pancreatitis.

Alcohol - the other common cause. How alcohol actually triggers the inflammation in the pancreas is not clear. Symptoms typically begin about 6-12 hours after a heavy drinking session. In some people pancreatitis can develop even after a small amount of alcohol. In these people, a 'sensitivity' to alcohol develops in their pancreas.

High blood fat levels - hypertriglycerdaemia. This is reported to cause 1 to 4 percent of all cases of AP and up to 56 percent of pancreatitis cases during pregnancy.

Uncommon causes - include the following:

Viral infections (for example, the mumps virus, HIV).

A rare side-effect to some medicines.

Injury or surgery around the pancreas

Infections with parasites (parasites are living things (organisms) that live within (or on) another organism).

High blood calcium levels.

Abnormal structure of the pancreas.

There is also a rare form of pancreatitis which can be inherited from a parent (hereditary).

Autoimmune - your own immune system attacks the pancreas. This can be associated with other autoimmune diseases - for example, Sjögren's syndrome and primary biliary cirrhosis.