What are the symptoms of pancreatitis?
The primary symptom of pancreatitis is abdominal pain.
Additional symptoms of acute pancreatitis may include:
- Nausea and vomiting.
- Fast heart rate.
- Fast, shallow breathing.
- Fever.
Additional symptoms of chronic pancreatitis may include:
- Indigestion and pain after eating.
- Loss of appetite and unintended weight loss.
- Fatty poops that leave an oily film in the toilet.
- Lightheadedness (from low blood pressure).
These are symptoms of your pancreatic functions beginning to break down.
What does the pain of pancreatitis feel like?
Abdominal pain from pancreatitis may be moderate to severe and may radiate to your back. Acute pancreatitis tends to be more severe, with a penetrating quality. Your abdomen may feel tender to the touch. With chronic pancreatitis, the pain may vary in intensity. It may come and go, but it typically doesn’t go away completely. You may notice it more after eating. For some people, the pain is constant.
It may feel worse when you:
- Lie flat.
- Cough.
- Exercise.
- Eat more.
It may feel better when you:
- Sit upright.
- Lean forward.
- Curl in a ball.
- Eat less.
What symptoms indicate that your pancreas isn’t working properly?
When long-term, chronic pancreatitis begins to affect your pancreatic function, you’ll notice it in your digestive system first. When your pancreas can no longer make and deliver its digestive enzymes, your body won’t be able to break down and absorb all the nutrients from your food. You may feel discomfort after eating and may begin passing undigested fats in your poop. Over time, you may notice weight loss.
What are the most common causes of pancreatitis?
The top two causes of pancreatitis are:
- Gallstones.
- Heavy drinking.
These causes together represent about 80% of pancreatitis cases.
Gallstone pancreatitis
Your common bile duct empties bile from your gallbladder into your intestine through the same opening as your pancreatic duct. If a gallstone enters the common bile duct and gets stuck at that junction, it can temporarily block the drainage of pancreatic juice from the pancreatic duct. This traps the enzymes inside your pancreas. As pressure builds up behind the obstruction, it activates the enzymes inside your pancreas and they begin digesting the pancreas itself. This causes the inflammatory response of gallstone pancreatitis.
Alcohol use
Heavy alcohol use is another clear cause of pancreatitis, though scientists aren’t sure why. It may be that the toxic byproducts of alcohol in your blood cause an inflammatory response in your pancreas, or they somehow chemically activate the digestive enzymes inside your pancreas. Scientists estimate that heavy alcohol use accounts for around half of both acute pancreatitis and chronic pancreatitis cases.
Other causes
Less common causes of pancreatitis include:
- Infections, such as viruses.
- Autoimmune disease (autoimmune pancreatitis).
- Inherited gene mutations (hereditary pancreatitis).
- Complications of cystic fibrosis.
- High blood triglyceride levels (hypertriglyceridemia).
- High blood calcium levels (hypercalcemia).
- Ischemia (reduced blood supply).
- Cancer.
- Traumatic injury to your pancreas.
- Certain medications that irritate the pancreas.
These causes together represent about 20% of pancreatitis cases. Occasionally, no cause is found.
Do acute and chronic pancreatitis have the same causes?
Most of the time, pancreatitis is acute and temporary. But causes that are chronic and don’t go away, such as inherited disorders, can cause chronic pancreatitis. Repeat episodes of acute pancreatitis can also lead to chronic pancreatitis. If your pancreas becomes inflamed too many times from repeated stress and injury, your body may learn to keep it constantly inflamed, even after the injury has stopped.
Can you die from pancreatitis?
You can die from complications of acute pancreatitis if it’s very severe. In a small percentage of people, severe acute pancreatitis causes a systemic reaction that affects the whole body. This can lead to shock and multiple organ failure, which can be fatal if it isn’t treated quickly. You may not be able to tell how severe your pancreatitis is, so you should go to the emergency room if you have symptoms.
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What are the possible complications of pancreatitis?
Most cases of acute pancreatitis don’t have complications, but 1 in 5 cases is more severe. It’s not clear why severe acute pancreatitis occurs in some cases and not others. A severe case can lead to serious complications, including death. Chronic pancreatitis also causes complications, but they develop more slowly and aren’t directly life-threatening. Most complications are manageable with treatment.
Acute pancreatitis
Complications of severe acute pancreatitis include:
- Necrosis and infection. One in 3 cases of severe acute pancreatitis causes so much swelling in your pancreas that it cuts off some of the blood supply. The loss of blood supply causes tissue death (necrosis) in parts of your pancreas. Necrotic (dead) tissue is a feast for roaming bacteria. When bacteria infect these tissues, they thrive and replicate, spreading to your bloodstream. Infection in your bloodstream (septicemia) is an emergency. Your body reacts to an infection in the bloodstream by activating an immune response against the infection (systemic inflammatory response syndrome, or SIRS). This immune response can cause your blood vessels to enlarge, which leads to a drop in blood pressure (septic shock) and decreased blood flow to your vital organs. This can cause multiple organ failure.
- Pancreatic pseudocysts. Inflammation in your pancreas can disrupt the pancreatic duct that feeds pancreatic juices to your intestine. This can cause pancreatic juices to leak out around the pancreas and cause inflammation of the surrounding tissue. Over time, the inflamed area forms a hardened capsule around the fluid, called a pseudocyst. Many pseudocysts don’t cause symptoms or need treatment. But they can occasionally become infected or become large enough to cause discomfort. Rarely, a blood vessel can erode into a pseudocyst and lead to bleeding inside the cyst. In these cases, your healthcare provider may need to intervene to drain the cyst or stop the bleeding.
- Chronic pancreatitis. Repeat episodes of acute pancreatitis can lead to chronic pancreatitis. Constant inflammation in your pancreas eventually leads to scarring of the tissues (fibrosis). Fibrosis in your pancreas interferes with its ability to function as a gland. Over time, it produces less and less of the enzymes and hormones your body needs, leading to further complications.
Chronic pancreatitis
Complications of chronic pancreatitis develop over time and can include:
- Exocrine pancreatic insufficiency (EPI), malabsorption and malnutrition. As fibrosis in your pancreas progresses, your pancreas produces less and less of the enzymes that your digestive system relies on. This causes the malabsorption of nutrients in your small intestine, especially fats and fat-soluble vitamins. Excess fats pass through your poop, causing fatty stools and eventually, chronic diarrhea. As you absorb less nutrition from your food, you could begin to lose weight and eventually feel the effects of the missing nutrients.
- Hypoglycemia, hyperglycemia and Type 1 diabetes. Chronic pancreatitis will also cause your pancreas to produce less of the hormones that regulate your blood sugar (glucose). Depending on which is affected first, you may experience symptoms from a lack of glucagon, which causes hypoglycemia (low blood sugar), or from a lack of insulin, which causes hyperglycemia (high blood sugar). Eventually, both hormone supplies are depleted, and diabetes develops.
- Chronic pain. While some people with chronic pancreatitis don’t experience pain or experience a remission of pain over time, others experience worsening pain that’s eventually constant. It can be challenging to manage, even with medication, and can affect your mental health, as well.
- Increased risk of pancreatic cancer. Chronic inflammation is a risk factor for cancer wherever it occurs. In people with chronic pancreatitis, the risk of pancreatic adenocarcinoma is between 1% and 2%. Symptoms are similar to those of chronic pancreatitis, so they might go unnoticed. Doctors recommend that people with chronic pancreatitis have regular cancer screening.
