Overview

Pancreatitis is a serious condition that occurs when the pancreas becomes inflamed. The pancreas is an organ that produces insulin and digestive enzymes. The same enzymes that help with digestion can sometimes injure the pancreas and cause irritation. This irritation can be short-term or long-term.Pancreatitis is inflammation of the pancreas and may be acute or chronic. Acute pancreatitis is acute inflammation of the pancreas and a common cause of acute abdominal pain causing hospitalization. In the majority of patients, the illness settles over a few days but in 25% of cases it is more severe and associated with organ failure or pancreatic necrosis, requiring critical care and a prolonged hospital stay. The pancreas can become inflamed if the digestive juices, called enzymes, attack the gland itself, causing damage to the tissues of the pancreas. Pancreatitis can be an acute or a chronic condition. Common causes of pancreatitis include gallstones that form in the nearby gallbladder and travel to the pancreas via the common bile duct; long-term, heavy alcohol use; and certain conditions such as cystic fibrosis.Management of acute pancreatitis in the early stages is supportive. Acute pancreatitis is marked by the onset of severe pain in the upper abdomen that may spread to the back. With proper treatment, acute pancreatitis can be managed and resolved, although the condition and its complications may be life threatening in some cases. About 200,000 people in the United States are hospitalized each year due to acute pancreatitis.Chronic pancreatitis is a long-term condition that can result in permanent damage. In this condition the pancreas is slowly destroyed until it can no longer produce the important digestive enzymes. Treatment may include a prescription for synthetic pancreatic enzymes.Some complications are common to acute and chronic pancreatitis such as malnutrition caused by digestive problems, diabetes, which occurs in up to 80% of those with chronic pancreatitis, and accumulation of fluid within local collections (pseudocysts), in the abdomen (ascites) or chest (pleural effusion). Managing all these complications may be difficult because of ongoing comorbidities and social problems, such as alcohol or opiate dependence.People with pancreatitis are at long-term risk of nutritional problems and diabetes, and also have an increased risk of pancreatic cancer, which is even higher in people with hereditary pancreatitis. It is necessary to identify those who need to be followed up and what tests are required.Pancreatitis is a serious and complex condition. It causes immense suffering, can have a severe effect on quality of life and may result in reduced life expectancy. In the past, there has been lack of knowledge on how to manage pancreatitis and this has resulted in clinicians avoiding those with the disease and conflicting advice being offered. With this guideline it is hoped that sound advice will be provided to enable people with pancreatitis to receive appropriate care to improve the outcomes from this difficult condition.

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