For an explanation of the pancreas, please see the description under "What is the pancreas?" in Pancreatic Diseases.
What is pancreatitis?
Pancreatitis is an acute or chronic inflammation of the pancreas. Acute attacks are often characterized by severe abdominal pain that radiates from the upper belly through to the back and can cause effects ranging from mild pancreatic swelling to life-threatening organ failure. Chronic pancreatitis is a progressive condition that results in permanent damage of pancreatic tissue. Recurrent acute attacks can lead to chronic pancreatitis.
The pancreas is a narrow, flat organ located deep in the abdominal cavity, behind the stomach and below the liver. It is composed of exocrine tissues, which make powerful enzymes that help digest fats, proteins, and carbohydrates in the small intestine, and bicarbonate that helps neutralize stomach acids. It also has "islets" of endocrine tissues that produce the hormones insulin and glucagon, vital for the transportation of glucose into the body's cells and for maintaining normal blood levels of glucose.
Normally, most pancreatic digestive enzymes are produced and transported into the duodenum in an inactive form. While the exact mechanisms of pancreatitis are not well understood, it is thought that during pancreatitis attacks these enzymes are prevented or inhibited from reaching the duodenum, become activated while still in the pancreas, and begin to autodigest and destroy the pancreas. They are also released directly into the blood, causing levels that are higher than normal and some secondary effects.
Pancreatitis occurs more frequently in men than in women and is known to be linked to and aggravated by alcoholism and gallbladder disease. In the latter case, this happens because of obstruction of the common duct from the gallbladder and the pancreas into the intestine. Obstruction is most frequently due to gallstones and sometimes to biliary sludge. Alcoholism and gallbladder disease are responsible for about 80% of acute pancreatitis attacks and figure prominently in chronic pancreatitis. Another 10% of the time the cause is idiopathic, and 10% of the time it is due to:
- Drugs such as valproic acid and estrogen
- Viral infections such as mumps, Epstein-Barr, and hepatitis A and B
- Exceedingly high blood triglyceride level, hyperparathyroidism, or high blood calcium level
- Cystic fibrosis and inherited defects that result in early activation of digestive enzymes
- Pancreatic cancer
- Surgery in the area of the pancreas (such as bile duct surgery)
- Trauma to the abdomen ("blunt trauma")