What is Pancreatitis?
Pancreatitis is inflammation of the pancreas — the gland behind the stomach that produces digestive enzymes and insulin. It ranges from mild, self-limiting acute episodes to severe, life-threatening necrotising pancreatitis, and chronic disease causing permanent pancreatic damage.
Dhaara Speciality Hospital provides complete pancreatitis care — from ICU management of severe acute pancreatitis to ERCP for ductal stones, surgical drainage procedures, and long-term management of chronic pancreatitis.
Acute vs. Chronic Pancreatitis
Acute Pancreatitis
Sudden inflammation that resolves with treatment. 80% are mild; 20% are severe and require ICU care. Can be life-threatening in necrotising form (30% mortality if infected necrosis develops).
Causes: Gallstones (50%), alcohol (25%), idiopathic, hypertriglyceridaemia, medications, ERCP-related
Chronic Pancreatitis
Progressive, permanent destruction of pancreatic tissue. Causes chronic abdominal pain, malabsorption (steatorrhoea), and diabetes. India has a specific form: Tropical Chronic Pancreatitis (TCP) — affecting young non-alcoholics, linked to malnutrition.
Causes: Alcohol (60%), tropical, idiopathic, genetic (PRSS1, SPINK1 mutations)
Symptoms
Acute Pancreatitis
- Severe upper abdominal pain radiating to back
- Pain worse after eating, relieved by leaning forward
- Nausea and vomiting
- Fever, rapid heart rate
- Abdominal tenderness and distension
- In severe cases: jaundice, shock
Chronic Pancreatitis
- Recurrent or continuous upper abdominal pain
- Pain worse after meals and alcohol
- Weight loss despite eating
- Oily, foul-smelling stools (steatorrhoea)
- Diabetes (late stage)
- Jaundice if bile duct blocked
⚠ Emergency: Severe upper abdominal pain with fever and vomiting — go to emergency immediately. Severe acute pancreatitis can cause multi-organ failure and requires ICU-level care.
Diagnosis
- Serum lipase / amylase: Elevated >3× normal confirms acute pancreatitis
- CT scan abdomen (contrast): CT Severity Index grades severity, detects necrosis, pseudocysts
- Ultrasound: Identifies gallstones, bile duct dilation
- MRCP (MR cholangiopancreatography): Detailed ductal anatomy without radiation or contrast — preferred for chronic pancreatitis
- ERCP: Both diagnostic and therapeutic — removes ductal stones, places stents
- Endoscopic Ultrasound (EUS): Detects small stones, strictures, early malignancy
Treatment
Acute Pancreatitis
- Aggressive IV fluid resuscitation — cornerstone of treatment, prevents pancreatic necrosis
- Pain management — IV opioids, epidural analgesia for severe cases
- Nutritional support — early enteral nutrition (nasojejunal tube) shown to improve outcomes
- Antibiotics — only for infected pancreatic necrosis (not prophylactically)
- ERCP within 24–72 hours — for gallstone pancreatitis with bile duct obstruction
- Cholecystectomy — after recovery from gallstone pancreatitis to prevent recurrence
- Interventional drainage — EUS-guided or surgical drainage of infected necrosis / large pseudocysts
Chronic Pancreatitis
- Complete alcohol cessation — single most important intervention
- Pancreatic enzyme supplementation — Creon for malabsorption and steatorrhoea
- Pain management — stepwise: analgesics → antioxidants → ERCP → surgery
- ERCP with ductal stone removal / stenting — for ductal obstruction causing pain
- Coeliac plexus block — EUS-guided nerve block for refractory pain
- Surgery — Frey procedure, Puestow procedure (lateral pancreaticojejunostomy), or Whipple for selected cases
- Diabetes management — Type 3c (pancreatogenic) diabetes requires careful management
Frequently Asked Questions
Can pancreatitis be cured completely?
Acute pancreatitis is a one-time episode in most cases — treat the episode, remove the cause (e.g., cholecystectomy for gallstone pancreatitis) and it does not recur. Chronic pancreatitis cannot be cured but progression can be slowed, pain managed, and complications treated effectively.
What foods should I avoid with pancreatitis?
During acute episodes: complete fasting or clear liquids only. Long-term: avoid alcohol completely, limit fat intake (especially fried, fatty foods), avoid large meals, eat small frequent meals, avoid smoking. High-fibre, low-fat diet is recommended.
Does pancreatitis lead to cancer?
Chronic pancreatitis is associated with a modestly increased risk of pancreatic cancer (approximately 2–3% over 20 years, versus 0.5% in the general population). Long-standing chronic pancreatitis warrants periodic surveillance with CT or EUS. Any new symptoms or weight loss should be promptly evaluated.