Pancreatitis: symptoms, causes, treatment and which doctor to see
Acute and chronic pancreatitis explained: the severe abdominal pain to act on, common causes such as gallstones and alcohol, tests and treatment.
Also known as: Acute Pancreatitis; Chronic Pancreatitis; Necrotizing Pancreatitis
What pancreatitis is
The pancreas is a gland that lies behind the stomach. It makes digestive enzymes that help break down food in the intestine, and hormones such as insulin that control blood sugar. Pancreatitis is inflammation of the pancreas. It happens when the digestive enzymes become active while still inside the gland and start to damage it.
There are two main forms. Acute pancreatitis comes on suddenly, usually over hours, and most people recover within a week or so with hospital treatment. Some, however, develop severe disease in which part of the pancreas dies (necrotising pancreatitis), infection sets in, or other organs such as the lungs and kidneys are affected, and this can be life-threatening. Chronic pancreatitis is long-lasting inflammation that slowly and permanently damages the pancreas, so it can no longer make enough enzymes or insulin. Repeated attacks of acute pancreatitis can lead to the chronic form.
Symptoms
Acute pancreatitis
- Sudden, severe upper abdominal pain, often in the centre or upper left side
- Pain spreading to the back, which may be worse after eating or lying flat and a little easier when leaning forward
- Nausea and vomiting
- Fever and a fast pulse
- A swollen, tender abdomen
Chronic pancreatitis
- Recurring or constant upper abdominal pain, though some people have little pain
- Weight loss even when eating normally
- Oily stools that are pale, bulky, foul-smelling and hard to flush, because fat is not being digested
- High blood sugar or diabetes, as insulin-producing cells are lost
Causes and risk factors
The two most common causes of acute pancreatitis are gallstones, which can block the duct the pancreas shares with the bile duct, and heavy alcohol use. Other causes include:
- Very high levels of triglycerides, a type of fat in the blood
- High blood calcium
- Certain medicines
- Injury to the abdomen, or a complication of ERCP, a procedure on the bile and pancreatic ducts
- Infections such as mumps in some cases
- Inherited conditions and abnormalities of the pancreatic duct
- Autoimmune pancreatitis, and rarely a tumour blocking the duct
Chronic pancreatitis is most often linked to long-term heavy drinking and smoking. In India, doctors also see a form of chronic pancreatitis in younger people who do not drink alcohol, sometimes called idiopathic or tropical pancreatitis, which has been described particularly in southern states. Its causes are still being studied, and genetic factors are thought to play a role. In some people no cause is found.
How it is diagnosed
For acute pancreatitis, the diagnosis is based on typical pain together with blood tests and, where needed, imaging:
- Lipase and amylase — enzymes from the pancreas that rise in the blood during an attack
- Other blood tests for liver function, triglycerides, calcium, kidney function and signs of severity
- Ultrasound of the abdomen, mainly to look for gallstones
- CT scan — used when the diagnosis is unclear or to assess severity and complications, usually a few days into the illness
- MRCP — a type of MRI scan that shows the bile and pancreatic ducts in detail without a procedure
Chronic pancreatitis is diagnosed mainly with imaging, which may show calcium deposits, a shrunken pancreas or an irregular duct, along with stool tests that check how well fat is digested and blood sugar tests. Endoscopic ultrasound is used at some centres.
Treatment
Acute pancreatitis
Acute pancreatitis needs hospital admission. Treatment focuses on supporting the body while the pancreas recovers: intravenous fluids to prevent dehydration and protect the kidneys, pain relief, oxygen if needed, and close monitoring. Many people can start eating again once the pain and nausea settle; others are given nutrition through a feeding tube. People with severe disease may need intensive care.
Treating the cause prevents repeat attacks. If gallstones are responsible, gallbladder removal, usually by keyhole surgery, is generally advised once you have recovered, often during the same admission or soon after. ERCP may be used to remove a stone stuck in the bile duct. Alcohol should be stopped completely. Collections of fluid or dead tissue that develop later are sometimes drained using endoscopic, radiological or surgical procedures.
Chronic pancreatitis
Treatment aims to control pain, replace what the pancreas can no longer make and prevent further damage. Pancreatic enzyme supplements, taken with meals, help digest food and reduce oily stools. Diabetes caused by pancreatitis is treated with medicines, often insulin. Stopping alcohol and smoking is essential. Endoscopic procedures or surgery can help some people with blocked ducts or severe pain.
Living with it and preventing attacks
- Avoid alcohol after an attack of pancreatitis, and stop completely if alcohol was the cause; ask your doctor what is safe for you
- Stop smoking, which speeds up damage in chronic pancreatitis
- If gallstones were the cause, do not delay the advised surgery
- Eat regular, balanced meals; a dietitian can advise on fat intake and nutrition if you have chronic pancreatitis
- Take enzyme supplements with every meal and snack as prescribed
- Have your blood sugar checked regularly, and keep follow-up appointments
When it is an emergency
Call 112 or 108, or go to the nearest emergency department, if you have:
- Sudden, severe abdominal pain that does not ease, especially if it spreads to the back
- Persistent vomiting, so that you cannot keep fluids down
- Fever with abdominal pain, or yellowing of the eyes or skin
- Fast breathing, a racing heartbeat, dizziness or confusion
- Very little urine
Do not try to manage severe abdominal pain at home with painkillers or antacids. Early hospital care, particularly fluids, makes a difference in acute pancreatitis.
Which doctor to see
Acute pancreatitis is usually first treated in an emergency department, then by a gastroenterologist or a general surgeon. A GI surgeon may be involved for gallbladder removal or complications. Chronic pancreatitis is followed by a gastroenterologist, often together with an endocrinologist for diabetes and a dietitian.
You can find gastroenterologists in Bengaluru or GI surgeons in Bengaluru on The Doctor Index, each with a registration you can check. Pain from pancreatitis is sometimes mistaken for indigestion, and diabetes from pancreatitis can cause high blood sugar.
Common questions
Questions people ask
- Can I drink alcohol again after pancreatitis?
- Doctors usually advise avoiding alcohol after pancreatitis. If alcohol caused the attack, drinking again greatly raises the risk of further attacks and chronic pancreatitis. Even when gallstones were the cause, alcohol can irritate a pancreas that is recovering. Ask for support if stopping is difficult.
- Is pancreatitis the same as pancreatic cancer?
- No. Pancreatitis is inflammation of the pancreas. However, long-standing chronic pancreatitis does increase the risk of pancreatic cancer over time, which is one reason regular follow-up with your gastroenterologist is important.
- Why do I need my gallbladder removed after gallstone pancreatitis?
- If gallstones caused the attack, more stones are likely to pass and trigger further attacks, which can be more severe. Removing the gallbladder greatly reduces this risk. People live normally without a gallbladder, as bile still flows from the liver into the intestine.
- What should I eat after an attack of pancreatitis?
- Most people start with light, low-fat meals as soon as they can eat comfortably, then return to a balanced diet. People with chronic pancreatitis may need enzyme supplements and advice from a dietitian. Your doctor will guide you based on how severe the attack was.
This condition is usually assessed by a gastroenterologist. Every profile shows the doctor’s registration and what has been checked.
Gastroenterologists in Bangalore
A few gastroenterologists listed on The Doctor Index. They are shown because of their speciality, not a stated interest in Pancreatitis; ask the clinic whether the doctor sees it.
Related conditions
- Celiac Disease
- Constipation
- Crohn's Disease
- Diarrhea
- Diverticulosis and Diverticulitis
- Foodborne Illness
- Gallstones
- Gastroenteritis
All gastroenterology conditions →
Practical reading
All postsSources
- MedlinePlus, US National Library of Medicine — Pancreatitis
- Government of India — Emergency Response Support System (112)
- MedlinePlus, National Library of Medicine — Pancreatitis — Public-domain health-topic summary
- Human Phenotype Ontology Consortium — terminology definitions — HPO licence; definitions reproduced without alteration
Pancreatitis: symptoms, causes, treatment and which doctor to see is original text by The Doctor Index; the compiled source draft was used for research. Source: MedlinePlus, National Library of Medicine. Orphadata Science: Free access data from Orphanet. © INSERM 1999; July 2026 data, CC BY 4.0. This product uses the Human Phenotype Ontology (hp/releases/2026-09-01). Only sources listed for this article apply. Source material has been selected and arranged; HPO definitions are reproduced without alteration. No source organisation endorses this compilation. Köhler S et al. The Human Phenotype Ontology project: linking molecular biology and disease through phenotype data. Nucleic Acids Research 2014;42(D1):D966–D974. doi:10.1093/nar/gkt1026.
General information, not advice about your situation. Errors can be reported through the corrections process. Reference TDI-C-1797.