Acute & Chronic Pancreatitis Symptoms & Treatment

Dr. Dana Sloane talks with a patient in a clinical setting.

What is pancreatitis?

Pancreatitis is a condition that involves the swelling or inflammation of the pancreas. The pancreas is a gland located below the stomach and adjacent to the intestines. It’s responsible for producing enzymes and hormones that help the body digest food and regulate blood sugar.

Medical illustration showing the location of the pancreas.

Pancreatitis may be acute (short-term) or chronic (long-term).

Acute pancreatitis is a sudden response to an event and may worsen over time, leading to complications, in some rare cases. It causes sustained pain that lasts hours, days, or several weeks.
Chronic pancreatitis is a long-term condition in which the pancreas has been permanently damaged by past inflammation. This condition causes constant or intermittent pain for years, worsening as time goes on. Patients with chronic pancreatitis have a decreased ability to secrete enzymes that aid digestion and hormones to regulate sugar metabolism. As a result, this is a lifelong condition that will need to be managed.

Repeated attacks of acute pancreatitis may lead to chronic pancreatitis, and patients with chronic pancreatitis can continue to have acute episodes. It is important to understand the symptoms and risk factors so you can reduce your chances of developing the disease or better manage it if it’s already developed.

At MedStar Health, our experienced clinicians address the root cause of your abdominal pain and offer innovative solutions to help you find relief. Working as a multidisciplinary team, our gastroenterology and pancreas experts partner with hepatobiliary surgeons, interventional radiologists, and others who specialize in pancreatic diseases. Through our Pancreas and Liver Diseases program, we have treated thousands of patients with acute and chronic pancreatitis. Our expertise and experience allows us to provide the highest level of patient-centered care, aimed at improving your quality of life.

What are the most common pancreatitis symptoms?

The primary symptom of both acute and chronic pancreatitis is severe pain in the middle or upper quadrants of the abdomen. However, everyone’s symptoms may be different.

Acute pancreatitis symptoms may include:

Pain in the middle of the abdomen, which may:
- Worsen after eating or drinking
- Worsen when lying flat on the back
- Radiate to the back, right or left upper quadrant, or below the shoulder blades
Nausea or vomiting
Bloating
Dehydration

People with chronic pancreatitis often lose weight, even when their appetite and eating habits are normal. The weight loss occurs because the body does not secrete enough pancreatic enzymes to digest food, so nutrients are not absorbed normally. Poor digestion leads to malnutrition due to excretion of fat in the stool. As a result, this condition can also cause:

Unintentional weight loss
Diarrhea
Oily stools

What causes pancreatitis?

The two most common causes of pancreatitis are alcohol and gallstones. Other less common causes include:

High triglyceride levels
Certain medications, such as steroids, estrogens, and some blood pressure medications
Obesity, which increases the risk of gallstones
Diabetes
Some viral infections, such as mumps, hepatitis B, and HIV,
Trauma, most common in pediatric patients
Genetic predisposition of pancreatitis,
Other autoimmune disorders
Smoking
Increasing age
Iatrogenic causes, such as ERCPs

How is it diagnosed?

Your first visit will involve a physical exam and a thorough review of your medical history and symptoms. Your healthcare provider will typically order several tests to further evaluate your pancreas, depending on your symptoms. These may include:

Imaging tests, such as MRIs, CT scans, CT/PET scans, or ultrasounds
Endoscopic ultrasound (EUS)
Endoscopic retrograde cholangiopancreatography procedure (ERCP)
Blood tests and other laboratory tests

How is pancreatitis treated?

Our goal is to allow the pancreas to heal, which often involves hospitalization and medicine to help manage your pain. All patients with pancreatitis are generally advised to avoid smoking, alcohol, and fatty foods. Additional pancreatitis treatment approaches will vary based on inflammation severity and whether it is acute or chronic.

For example, mild cases of acute pancreatitis may resolve on their own. In other instances, moderate or severe cases often require hospitalization. Food may be restricted to limit the activity of the pancreas, which means you may receive intravenous (IV) fluids. Treatment may include draining fluid from in or around the pancreas if necessary, in severe cases. More commonly, acute pancreatitis may involve removal of gallstones or other blockages that caused the inflammation.

Managing chronic pancreatitis and pain

Patients with chronic pancreatitis will typically need additional treatment and management, such as:

Long-term chronic pain management
Enzyme supplements to aid in digestion
Dietary changes
Regular screenings for pancreatic cancer

In severe chronic cases (called necrotizing pancreatitis), surgery may be needed to remove dead or infected pancreatic tissue. New endoscopic approaches are available now that allow us to drain excess inflammatory fluid or dead tissue using less invasive methods.

At MedStar Health, our team of experts can evaluate and determine the best course to relieve debilitating pain. A multidisciplinary approach to treatment is our goal-directed therapy. Our team of experienced endoscopists and transplant surgeons are highly-trained in tackling the causative problem and coming up with the best treatment plan. This may include endoscopic approaches, and, if necessary, the innovative option of auto islet cell transplant with total pancreatomy through our MedStar Georgetown Transplant Institute.

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