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What is it?

 

Pancreatitis can be an acute or chronic inflammation of the pancreas. Acute attacks often are characterised by severe abdominal pain that radiates from the upper stomach through to the back and can cause effects ranging from mild pancreas swelling to life-threatening organ failure. Chronic pancreatitis is a progressive condition that may involve a series of acute attacks, causing intermittent or constant pain as it permanently damages the pancreas.

The pancreas is a narrow, flat organ located deep in the abdominal cavity behind the stomach and below the liver. It is composed of exocrine tissues, which make powerful enzymes that help digest fats, proteins, and carbohydrates in the small intestine and bicarbonates that help neutralise stomach acids. It also has ‘islets’ of endocrine tissue that produce the hormones insulin and glucagon, vital for the transportation of glucose into the body's cells. For more detail see "What is the pancreas?" in Diseases of the pancreas.

Normally, the pancreatic digestive enzymes are created and carried into the duodenum (first part of the small intestine) in an inactive form. It is thought that during pancreatitis attacks, these enzymes are prevented or inhibited from reaching the duodenum, become activated while still in the pancreas, and begin to auto-digest and destroy the pancreas.

While the exact mechanisms of pancreatitis are not well understood, it is more frequent in men than in women and is known to be induced by chronic alcohol abuse and gall stones (gallstones that block the bile duct where it runs through the head of the pancreas and meets the pancreatic duct, just as it joins the duodenum). These two conditions are responsible for about two thirds of acute pancreatitis attacks and figure prominently in chronic pancreatitis. In the remainder of cases the cause is idiopathic (unknown, around 15-25 per cent) or may be due to conditions such as:

  • Hypertriglyceridaemia, hyperparathyroidism or hypercalcaemia
  • Drugs such as valproic acid and oestrogen
  • Viral infections such as mumps, Epstein-Barr, and hepatitis A and B 
  • Trauma to the pancreas

Last Review Date: September 5, 2017