Patient information · Gastroenterology
Pancreatitis
an acute attack is a hospital emergency
Pancreatitis is inflammation of the pancreas. An acute attack causes severe upper abdominal pain boring through to the back and requires hospital admission — it is not something to manage at home. Most attacks are caused by gallstones or alcohol, and both causes are preventable once identified.
Call 999 or go to an emergency department if you have
- severe upper abdominal pain radiating through to the back
- pain relieved by leaning forward and worse lying flat
- persistent vomiting and inability to keep fluids down
- fever, rapid heartbeat or feeling very unwell
- yellowing of the skin or eyes
- a distended, tender abdomen, or bruising around the navel or flanks
Acute pancreatitis can progress to organ failure within hours and always needs hospital assessment with blood tests and imaging. Do not attempt to manage severe upper abdominal pain at home. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
Causes
- Gallstones — around half of cases. A stone blocks the duct where it joins the pancreatic duct.
- Alcohol — most of the remainder, usually after years of heavy drinking or a binge.
- High triglycerides — a recognised and treatable cause, often overlooked.
- Medicines — including azathioprine, some diuretics, valproate and GLP-1 agonists.
- After ERCP, trauma, high calcium, infections, and genetic causes.
- In a proportion no cause is found, and that warrants proper investigation rather than acceptance.
What happens in hospital
- Blood tests — amylase or lipase confirms the diagnosis, plus liver function, calcium, triglycerides and inflammatory markers.
- Ultrasound to look for gallstones; CT if the picture is unclear or complications are suspected.
- Intravenous fluids, pain relief and monitoring — the mainstay of treatment.
- Early feeding is now encouraged rather than prolonged starvation.
- Gallbladder removal during the same admission or within two weeks where gallstones were the cause — delaying it risks a further attack.
Do not leave gallstone pancreatitis untreated
If gallstones caused your attack, the risk of another is substantial — and each attack carries its own risk of serious complications. Cholecystectomy should follow promptly, ideally during the same admission or within two weeks. If you have had gallstone pancreatitis and are still waiting months later with your gallbladder in place, that warrants chasing rather than accepting.
Chronic pancreatitis
Repeated or prolonged inflammation causes permanent scarring, so the pancreas stops producing enough digestive enzymes and insulin.
- Persistent or recurring upper abdominal pain, often worse after eating
- Pale, greasy, foul-smelling stools that float and are hard to flush — steatorrhoea, from undigested fat
- Weight loss despite eating normally, and vitamin deficiencies
- Diabetes, developing as insulin-producing cells are lost
- Alcohol is the commonest cause; smoking independently accelerates it
Living with chronic pancreatitis
- Complete alcohol abstinence and stopping smoking — the two things that most alter the course.
- Pancreatic enzyme replacement (PERT) with every meal and snack containing fat. Doses are commonly too low; if stools are still greasy, the dose needs increasing rather than the diet restricting further.
- Do not follow a very low fat diet. Modern practice is a normal-fat diet with adequate enzymes, because fat restriction causes malnutrition and vitamin deficiency.
- Fat-soluble vitamins (A, D, E, K) and bone density monitoring — osteoporosis is common and under-recognised.
- Diabetes screening at least annually.
- Specialist pain management; opioids are used cautiously.
Why come to us. An acute attack belongs in hospital. Where we help is before and after: identifying gallstones with ultrasound on site in someone with recurrent upper abdominal pain, checking triglycerides, calcium, liver function and HbA1c in-house for a treatable cause, arranging prompt gallbladder surgery through our CQC-registered partners, and providing the follow-up so often missed — enzyme dosing, vitamin levels, bone health and diabetes screening. Seven days a week.
Ultrasound on site, and the follow-up nobody arranges
Bloods in-house, surgery arranged fast. Acute pain: go to A&E.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.