What it is, what causes it, how it is treated, and what to expect.
This leaflet explains acute pancreatitis: what it is, the symptoms it causes, common causes, how doctors assess how severe it is, how it is treated, and what the short- and long-term outlook usually looks like. It is intended as general background information to support, not replace, the advice of your own clinical team.
Acute pancreatitis is sudden inflammation of the pancreas, the gland that sits behind your stomach and helps digest food and control blood sugar (see our separate leaflet, "My Pancreas", for more on its normal role). In acute pancreatitis, digestive enzymes that are usually only active once they reach the small bowel become switched on too early, inside the pancreas itself. This causes the gland to become inflamed and, in more severe cases, damaged.
It is one of the most common reasons for emergency hospital admission with abdominal pain. Most people (around 4 in 5) have a mild episode and make a full recovery within a week or so. A smaller number of people become more unwell and need a longer stay in hospital, sometimes including a period of high dependency or intensive care.
Acute pancreatitis is a different condition from chronic pancreatitis, which is long-standing, ongoing inflammation and scarring of the pancreas. Some people who have repeated attacks of acute pancreatitis, particularly if the underlying cause is not addressed, can go on to develop chronic pancreatitis over time.
The most common symptom is pain, but acute pancreatitis can present in several ways:
Because these symptoms overlap with other causes of abdominal pain, doctors rely on a combination of your history, examination, blood tests and sometimes imaging to confirm the diagnosis (see "How is it diagnosed?" below).
There are many possible causes, though two account for the large majority of cases in the UK:
Other, less common causes include:
Identifying the cause matters because treating it (for example, removing the gallbladder after gallstone pancreatitis, or supporting someone to reduce or stop alcohol) significantly lowers the chance of a further attack.
Diagnosis is usually based on at least two of the following three things being present:
Alongside these, your team will usually arrange blood tests to look for a likely cause (such as liver function tests and a check of your triglyceride and calcium levels), and tests such as CRP and a full blood count to help judge how your body is responding. An abdominal ultrasound is commonly done early on to look for gallstones. A CT scan is not always needed straight away; it is more useful a few days into the illness if the diagnosis is uncertain, or to look for complications if you remain unwell.
Not all acute pancreatitis is the same, and part of your team's job in the first 24–48 hours is working out how severe your episode is likely to be, because this guides how closely you need to be monitored and where you are best cared for. Doctors commonly use scoring systems (such as the Glasgow-Imrie score or APACHE II) that combine things like your age, blood test results, and how your organs are functioning, to help flag people at higher risk early on.
Severity is formally categorised using the following framework (the "revised Atlanta classification"), based on whether any organs are affected and for how long:
Certain factors make a more severe course more likely, including older age, obesity, and pancreatitis caused by alcohol. Your team will monitor you closely in the first few days regardless of your initial severity, since some people who start off looking well can deteriorate.
For almost everyone, the mainstay of early treatment is supportive care while the inflammation settles:
Antibiotics are not routinely given, because acute pancreatitis is caused by inflammation rather than infection in the first instance; they are reserved for when there is evidence of an actual infection, such as infected pancreatic necrosis.
If you develop moderately severe or severe pancreatitis, you may need care on a high dependency or intensive care unit for support of your breathing, circulation or kidneys. Some people develop collections of fluid or dead pancreatic tissue (necrosis) around the pancreas; these are initially watched, and only treated (usually by a minimally invasive drainage procedure, and occasionally by surgery) if they become infected or are causing symptoms. Wherever possible, less invasive, delayed treatment is preferred over early surgery, as this tends to give better outcomes.
Most people with mild acute pancreatitis recover fully within about a week and leave hospital with no lasting problems. In a smaller proportion of people, complications can develop, particularly with moderately severe or severe disease (see the leaflet on Complications of Pancreatitis for more detailed information):
Overall, acute pancreatitis has a low mortality rate (roughly 1–2% across all cases) but this rises considerably in severe disease with persistent organ failure or infected necrosis, where it can reach around 20–30%. This is why early recognition of severe disease and prompt, specialist supportive care make such a difference. Length of hospital stay varies from a few days for mild disease to several weeks or months for severe disease.
Most people who have a single, mild episode of acute pancreatitis recover completely, with a pancreas that continues to work normally. However, some people experience longer-term effects, particularly after more severe or repeated episodes:
Because of these possibilities, you will usually be offered follow-up after your admission: to check recovery, address the underlying cause if this has not already been done, and arrange further tests (such as scans, or blood tests for blood sugar and vitamin levels) if needed.
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In an emergency, call 999. For urgent health advice, call NHS 24 on 111.
