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.
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.
Pancreatitis means inflammation of the pancreas. There are two types:
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.
Gallstones or alcohol is the cause in more than 8 out of 10 cases. Other causes are rare.
The digestive chemicals (enzymes) that are made in the pancreas become activated and start to 'digest' parts of the pancreas. They are normally only activated after they reach the part of the gut just after the stomach (the duodenum). This leads to a range of chemical reactions that cause inflammation in the pancreas. How the above causes trigger this sequence of events is not clear.
Acute pancreatitis can even be life-threatening.
You will need to be admitted to hospital if the best gastrology doctor in Kolkata suspects that you have acute pancreatitis. There are lots of causes of tummy (abdominal) pain and being sick (vomiting), so tests are done to rule out other problems and to confirm the diagnosis. Blood tests can check the blood level of amylase and/or lipase (these are enzymes made by the pancreas). Although not 100% reliable, a high blood level of these enzymes strongly suggests that pancreatitis is the cause of your symptoms.
An ultrasound scan may be done to look for a gallstone if this is the suspected underlying cause. Other types of scans may be needed if an ultrasound scan does not give a clear answer.
The treatment depends on how bad your attack of acute pancreatitis is. There is no specific treatment that will take the inflammation away. However, in most cases, pancreatitis settles over a few days, although symptoms can get worse before they get better.
Less commonly, complications develop and the situation can become very serious. Other treatments that may then be needed include the following:
As mentioned, acute pancreatitis is classified as mild if no complications develop (about 4 in 5 cases). In this case, the outlook is very good and full recovery is usual.
Severe acute pancreatitis (about 1 in 5 cases) means that one or more complications develop. Despite intensive care treatment, up to 50% of people with severe acute pancreatitis can die.
An attack of acute pancreatitis may be a one-off event. However, if there is an underlying cause, then it may happen again (recur) unless the cause is corrected. One of the following may be relevant to prevent a recurrence, depending on the particular cause:
