Written by J. Patrick Herrington, M.D.
The pancreas is a digestive organ sitting behind the stomach that makes chemicals (enzymes) that help regulate blood sugar and help in the digestion or breakdown of food so that it may be more easily digested.
Pancreatic enzymes, which are types of chemicals, are made by the pancreas for digestion and are very powerful. So much that they are wrapped in a protective covering when they are within the pancreas. When food is eaten and travels to the stomach a signal is sent to release the pancreatic enzymes into the small intestines through the pancreatic ductal system. When the enzymes reach the small intestines and are completely out of the pancreas, the covering of the enzyme is removed in this manner. The enzymes are activated and are able to digest food when they are outside of the pancreas. When pancreatic enzymes become prematurely unwrapped or activated while they are still inside the pancreas, they begin to digest the pancreas. This auto digestion of the pancreas by pancreatic enzymes is what causes acute pancreatitis.
When acute pancreatitis occurs, most commonly because of significant alcohol ingestion, or the passage of gallstones through the bile duct temporarily causing a pancreatic tube obstruction, the pancreas becomes inflamed and the patient most often develops severe abdominal pain rather suddenly. The pain is most often located in the center of the upper abdomen, but can also occur on the left or right side, although this is less common. This pain will often bore through from the front of the abdomen to the back. It is usually accompanied by nausea and vomiting and very often the patient may develop a fever. This pain is generally severe to the point that they will visit a physician within 24 hours and often have to go to the emergency room because of the intensity of the pain.
Most cases of acute pancreatitis requires admission to the hospital. The majority of the time, even though the initial symptoms are quite severe, the situation will improve quickly and the patient may stay in the hospital for only a few days. While in the hospital the patient will most often receive pain medications, intravenous fluids and anti-nausea agents. About 10% of cases of acute pancreatitis are very serious. Inflammation of the pancreas could lead to impairment in the lung and kidney function or even infection. These issues may in turn require transfer of the patient to an intensive care unit. Sometimes a breathing tube or kidney dialysis is needed. Severe cases of acute pancreatitis can be life threatening.