Pancreatitis, inflammation of the pancreas, is increasingly common, with acute pancreatitis affecting around 30-40 per 100,000 people yearly and leading to hundreds of thousands of hospitalizations in the US annually, while chronic pancreatitis is less common, affecting about 8 per 100,000 new cases each year but rising due to factors like gallstones, obesity, and alcohol. While acute cases often resolve, some progress to chronic forms, which are more prevalent in middle-aged men.
The global incidence of AP has been estimated to be 33.74 cases per 100,000 person-years [6]. Approximately 10%–30% of patients with AP undergo recurrent attacks [7] and about 10% of patients with first-attack AP will develop chronic pancreatitis [8].
Early signs of pancreas problems often include upper abdominal pain radiating to the back, nausea, vomiting, and digestive issues like fatty, foul-smelling stools, but can also manifest as new-onset diabetes, unexplained weight loss, fatigue, or jaundice (yellowing of skin/eyes). These symptoms, particularly persistent pain or significant weight loss, warrant immediate medical attention as they can signal conditions like pancreatitis or pancreatic cancer, says Mayo Clinic, Cancer Australia, and National Institutes of Health (NIH) | (.gov).
There were 236 255 admissions for a principal diagnosis of acute or chronic pancreatitis between 2006/07 and 2018/19, corresponding to an average admission rate of 48.48/105/year. The majority (88.4%, n = 208 390) of these were for AP, equating to an average admission rate of 46.03/105/year.
The most common cause of AP after cholecystectomy is retained biliary stone or sludge, but surgical complications can also cause AP.
The symptoms include fatty food intolerance, nausea, vomiting, heartburn, flatulence, indigestion, diarrhea, jaundice, and intermittent episodes of abdominal pain. Post-cholecystectomy syndrome can present early, typically in the post-operative period, but can also manifest months to years after surgery.
People with chronic pancreatitis may have no symptoms until the condition has caused severe damage to the pancreas. However, abdominal pain that spreads to the back remains the most common warning sign. Chronic pancreatitis may also cause diarrhea, weight loss, or greasy, unusually foul-smelling stools.
Still, those who do are at risk for recurrent episodes and progression to chronic pancreatitis with endocrine and exocrine insufficiency, diabetes mellitus, and increased pancreatic cancer risk. Alcohol is also the most common cause of chronic pancreatitis in the United States.
Most surgeons adhere to the 'Rule of 6' for the management of pancreatic pseudocysts (that is cysts >6 cm or duration >6 weeks).
Acute pancreatitis commonly affects people in their 30s, while chronic pancreatitis is commonly diagnosed among people in their 50s. Younger people with chronic pancreatitis often have inherited the condition. When people are admitted to the hospital with abdominal pain, acute pancreatitis is the most common diagnosis.
Blood tests can give clues about how the immune system, pancreas and related organs are working. Ultrasound images can show gallstones in the gallbladder or inflammation of the pancreas. CT scan can show gallstones and the extent of inflammation.
The differential diagnosis for pancreatitis includes an ulcer of the stomach or duodenum, liver inflammation, small bowel obstruction, functional bowel disorders, abdominal aortic aneurysm, an obstruction of the intestine and pancreatic cancer.
To heal your pancreas fast, you need to rest it by avoiding alcohol, smoking, and fatty foods, while focusing on a low-fat diet of lean proteins, fruits, veggies, and whole grains, staying hydrated with water and broths, and getting medical care for severe pain, which might involve IV fluids or even temporary fasting under doctor supervision to reduce strain. Working with a dietitian and addressing the underlying cause (like gallstones) with a doctor is crucial for recovery and preventing future attacks.
Acute pancreatitis is more common in middle-aged and elderly people, but it can affect people of any age. Men are more likely to develop alcohol-related pancreatitis, while women are more likely to develop it as a result of gallstones.
Several studies indicate that a high dietary glycemic load [27], fat, meat, egg etc. [28] were associated with the risk of non-gallstone-related acute pancreatitis.
Pancreatitis (acute or chronic) shortens life expectancy compared to the general population, with survival rates varying greatly; for chronic pancreatitis, 10-year survival can be 70%, but complications like diabetes, pancreatic cancer, smoking, and alcoholism significantly reduce lifespan, while severe acute pancreatitis also carries higher mortality, with life expectancy decreasing as the number of episodes increases.
Chronic pancreatitis symptoms may include:
Though food alone does not contribute to pancreatitis treatment, people with pancreatitis benefit from dietary adjustments and other lifestyle changes. Though acute pancreatitis normally cures in one to two weeks, solid meals are usually avoided during this time to reduce the stress on the pancreas.
Chronic, heavy alcohol use is also a common cause. Acute pancreatitis can occur within hours or as long as 2 days after consuming alcohol. Other causes of acute pancreatitis include abdominal trauma, medications, infections, tumors, and genetic abnormalities of the pancreas.
You should go to the ER immediately for pancreatitis if you have severe, persistent upper abdominal pain radiating to your back, accompanied by intense nausea, vomiting, fever, fast heartbeat, shortness of breath, or jaundice (yellow skin/eyes). Acute pancreatitis is a medical emergency needing prompt hospital care to manage severe symptoms and prevent serious complications like tissue death, organ failure, or infection.
Autoimmune Pancreatitis
AIP can occur by itself or in association with other autoimmune diseases such as primary sclerosing cholangitis (PSC), primary biliary cirrhosis, retroperitoneal fibrosis, rheumatoid arthritis, sarcoidosis, and Sjögren's syndrome.
Your doctor may remove damaged tissue from your pancreas. Endoscopic Cholangiopancreatography (ERCP). Doctors use ERCP to treat both acute and chronic pancreatitis. ERCP combines upper gastrointestinal endoscopy and x-rays to treat narrowing or blockage of a bile or pancreatic duct.
“Silent,” or painless, chronic pancreatitis (CP) exists when patients with diagnostic features of CP describe no abdominal pain. It is a poorly understood phenomenon but it is important as it may go unnoticed until serious complications arise, including pancreatic insufficiency, diabetes, and even cancer.
Summarizing this topic, chronic stress appears as a risk factor to develop pancreatitis by sensitizing the exocrine pancreas through TNF-α, which seems to exert its detrimental effects through different pathways (Figure 2).