Pancreatitis: symptoms, causes, treatment and recovery

The NHS says the main symptom of acute pancreatitis is pain in the tummy. You may also have a high temperature and feel sick or be sick. The pain may start suddenly and not go away, be severe, sharp or knife-like, affect the upper part of the tummy (between the ribs), one side or the whole tummy, spread to the sides and back, feel worse after eating, moving around or lying down, and feel better when leaning forward or bringing your knees to your chest.

For chronic pancreatitis, the NHS says the pain may be constant or come and go, severe or like a dull ache, better sitting down and leaning forward, and worse after eating. Other symptoms can include feeling or being sick, diarrhoea, very smelly poo that floats and is difficult to flush away, bloating, being thirsty or needing to pee a lot, and losing weight without trying to.

The NHS says acute pancreatitis is a serious condition where the pancreas suddenly becomes swollen and painful (inflamed) and that it is different from chronic pancreatitis, a long-term condition where the pancreas has become permanently damaged. NICE Clinical Knowledge Summaries describes chronic pancreatitis as chronic, irreversible inflammation and/or fibrosis of the pancreas.

NICE Clinical Knowledge Summaries says acute pancreatitis may be mild, moderately severe or severe. Mild pancreatitis is the most common form, usually has an uneventful recovery and resolves in the first week.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if you get sudden, severe tummy pain that does not go away or keeps coming back, or comes with a high temperature or feeling hot, cold or shivery. If a GP thinks you have acute pancreatitis they will refer you to hospital for tests straight away.

Call 999 or go to A&E, the NHS says, if you get sudden, severe tummy pain and any of the following. Do not drive yourself; ask someone to drive you or call 999.

• the pain is spreading to your back

• bloating that does not go away or keeps coming back

• a fast heartbeat or difficulty breathing

• the skin around the belly button, waist or upper outer thigh appears blue or bruised (this may be more difficult to see on black or brown skin)

The NHS says acute pancreatitis is usually diagnosed using blood tests and sometimes a CT scan, and needs treatment in hospital straight away. You will be monitored to see how serious the condition is and whether it is causing other problems such as infection. Hospital treatment may include fluids and nutrients given through a tube into a vein, painkillers, and antibiotics if there is an infection. You may also need treatment for the underlying cause, such as surgery for gallstones or support to stop drinking alcohol.

For chronic pancreatitis, the NHS says there is currently no cure but treatment can help manage symptoms and related problems. This may include painkillers, medicines that help the body absorb nutrients from food, medicines for diabetes such as insulin, and surgery to remove cysts or unblock the pancreas or bile ducts. You will be supported by different healthcare professionals, which may include your GP, specialist doctors, nurses and dietitians.

For acute pancreatitis, the NHS says most people start to get better within a week and can leave hospital in 5 to 10 days. If you have severe pancreatitis or it is causing other problems, you may need to stay longer. NICE Clinical Knowledge Summaries says mild acute pancreatitis usually resolves in the first week.

The NHS says most people with acute pancreatitis recover fully, but some develop serious complications that need treatment. Chronic pancreatitis is long term, and the NHS says there is no cure.

The NHS says the most common causes of acute pancreatitis are gallstones, which can block the opening of the pancreas, and drinking a lot of alcohol. NICE Clinical Knowledge Summaries says these account for around 75% of cases. Less common causes listed by the NHS are injury to the pancreas such as during surgery, certain medicines (including some steroids, heart and epilepsy medicines), and conditions such as lupus, mumps, pancreatic cancer or high calcium levels in the blood.

The NHS says the most common cause of chronic pancreatitis is drinking alcohol. If you keep drinking and keep getting acute pancreatitis, the pancreas can eventually become permanently scarred. It can also be linked to smoking, genes (including the gene that causes cystic fibrosis, the most common cause in children), the immune system attacking the pancreas, and the pancreas not developing properly.

The NHS lists complications of acute pancreatitis as cysts in the pancreas, which often go away on their own, pancreatic necrosis, where tissue in the pancreas dies and needs surgery and antibiotics to prevent sepsis, and chronic pancreatitis if you keep getting acute attacks. It says acute pancreatitis can be life-threatening.

For chronic pancreatitis, the NHS lists difficulty absorbing nutrients (leading to weight loss and weakened bones), type 3c diabetes, cysts that can become infected or bleed, blockages in the pancreas or bile ducts, and a higher risk of pancreatic cancer.

The NHS says that if you have had acute pancreatitis once, it is possible to get it again. It suggests drinking less alcohol or none at all, stopping smoking, and eating a healthy, low-fat diet.

For chronic pancreatitis, the NHS says to eat a healthy, balanced diet to get the nutrients you need, not to drink alcohol, because it can cause more damage even if the condition was not caused by alcohol, and to stop smoking, which can help slow the damage. NICE Clinical Knowledge Summaries adds that pancreatic enzyme replacement therapy and fat-soluble vitamin supplements may be used where there is malabsorption.

The NHS and NICE pages read for this guide do not give pregnancy-specific advice. NICE Clinical Knowledge Summaries lists gallstones as a major cause of acute pancreatitis, and sudden severe upper tummy pain at any stage of pregnancy should be assessed urgently, so call NHS 111 or your maternity unit, or 999 if it is severe.

Suspected acute pancreatitis is an emergency and is managed through 999, A&E or an urgent GP referral to hospital. NICE Clinical Knowledge Summaries says admission should not be delayed by arranging blood tests or imaging in primary care. Chronic pancreatitis is usually managed by a GP with a hospital specialist and dietitian, and private gastroenterology review, scans and dietitian appointments are available for follow-up if you choose to pay or have insurance.