What Causes Acute and Chronic Pancreatitis?

You’ve probably heard of pancreatitis and how painful it is. 

If you’ve experienced pancreatitis yourself, you might be wondering what caused it and what you can do to help keep it from happening again.

In this article, we’ll cover the causes of pancreatitis, diagnosis, and treatment of pancreatitis, and leave you with some ways you can help prevent pancreatitis.

What is pancreatitis?

The pancreas is a long, flat gland located behind your stomach in your upper abdomen. It secretes enzymes that aid in digestion and is responsible for producing insulin, a hormone that helps lower your blood sugar levels.

Your pancreas connects to the beginning of your small intestine and empties digestive enzymes into your small intestine from a pancreatic duct. The pancreatic enzymes include amylase (which breaks down carbohydrates), lipase (which breaks down fats), as well as trypsin and chymotrypsin (which breaks down proteins).

Pancreatitis is a painful condition where your pancreas becomes inflamed. The inflammation of your pancreas occurs when digestive enzymes are trapped in your pancreas and then begin to eat at the pancreas itself.

There are two types of pancreatitis; acute and chronic. Acute pancreatitis is short-lived and usually resolves within days to weeks, while chronic pancreatitis is an ongoing health issue that can last months or years. Men are more likely to develop acute pancreatitis compared to women.

Symptoms of pancreatitis include:

  • Upper abdominal pain
  • Abdominal pain that radiates to your back
  • Tenderness when touching your abdomen
  • Fever
  • Rapid pulse
  • Nausea
  • Vomiting

Chronic pancreatitis signs and symptoms include:

  • Upper abdominal pain
  • Abdominal pain that feels worse after eating
  • Losing weight without trying
  • Oily, smelly stools (steatorrhea) due to a lack of pancreatic enzymes that help break down fats

how to relieve pancreatitis pain

What causes pancreatitis?

When everything is working as it should, the digestive enzymes made by the pancreas aren’t activated until they reach your digestive system. 

Pancreatitis occurs when the pancreatic duct is blocked. Once the pancreatic duct is blocked, digestive enzymes activated within the pancreas start to eat at your pancreas, which causes inflammation.

The two main causes of pancreatitis are alcohol abuse and gallstones.

Chronic alcohol abuse causes your body to make thicker, more viscous secretions which can block the pancreatic ducts and lead to pancreatitis. (2)

Gallstones (solid masses composed of cholesterol and other substances) can get caught in a pancreatic duct, blocking the exit of pancreatic enzymes. This type of acute pancreatitis is gallstone pancreatitis.

What are the risk factors for pancreatitis?

The most common risk factors for developing pancreatitis are:

  • Excessive alcohol use
  • Cigarette smoking
  • Having gallstones
  • Obesity
  • Having diabetes
  • Having a family history of pancreatitis

Pancreatitis can also be triggered by:

  • Taking certain medications (more on that next)
  • High triglyceride levels in the blood (hypertriglyceridemia)
  • Pancreatic cancer
  • Abdominal surgery
  • Cystic fibrosis
  • Infection
  • Injury to your abdomen
  • Trauma

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Which drugs can cause pancreatitis?

Some drugs may cause an increased risk of pancreatitis by causing inflammation of the pancreas, among other mechanisms. 

Some of the drugs known to be correlated with bouts of acute pancreatitis include (3):

Angiotensin-Converting Enzyme Inhibitors

Also called ACE inhibitors, these medications treat high blood pressure. Examples of ACE inhibitors include those ending in “pril,” such as Lisinopril.

Statins

Statins are a class of medications that can treat high cholesterol. Statin drug names end in “statin,” such as lovastatin and atorvastatin.

Oral Contraceptives/Hormone Replacement Therapy

Oral contraceptives might increase your triglyceride levels, which is a risk factor for developing pancreatitis. 

Diuretics

Diuretics keep you from retaining fluid, which can help treat conditions like heart failure and high blood pressure. Common diuretics are furosemide (Lasix) and spironolactone. 

Highly Active Antiretroviral Therapy

Medications used to treat HIV (human immunodeficiency virus) can be toxic to the pancreas and cause negative side effects that are associated with acute pancreatitis. Protease inhibitors are the type of medication used to treat HIV and end in “avir,” such as Atazanavir.

Valproic Acid

Valproic acid is an anticonvulsant medication to treat epilepsy, a seizure disorder. The risk of pancreatitis among patients taking valproic acid increases among patients with a history of drug sensitivities.

Hypoglycemic Agents

Medications used to treat high blood sugar (diabetes) carry a small risk of pancreatitis. 

The glucagon-like peptide-1 (GLP-1) drugs carry a “disproportionately increased risk of pancreatitis.” This drug class includes brand names Ozempic and Trulicity. A six-fold increase in pancreatitis risk is associated with Byetta, a type of GLP-1 receptor agonist.

Diagnosis and treatment of pancreatitis

Diagnosis

Doctors can diagnose pancreatitis through certain blood tests and imaging, including abdominal ultrasound, computerized tomography (CT) scan, magnetic resonance imaging (MRI), and endoscopic ultrasound. They may also use stool tests to determine if there is excess fat in your stools, which can indicate a lack of digestive enzymes.

Treatment

You can treat pancreatitis with rest (including a low-fat diet), IV fluids to treat any dehydration, pain medication, and antibiotics if an infection is present. 

If you can’t eat, you might receive nutrition through a nasogastric (NG) tube or an IV to give your digestive tract time to rest.

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a procedure that can diagnose issues with your pancreas. A gastroenterologist (a doctor specializing in the digestive system) can use ERCP to remove gallstones that might be blocking your pancreatic duct and causing your pancreatitis.

Surgical Treatment

If gallstones cause pancreatitis, your doctor may recommend the removal of your gallbladder (cholecystectomy).

If you develop an abscess of a pseudocyst, a healthcare specialist will drain the extra fluid from your abdomen and may remove any damaged areas of your pancreas.

How to prevent pancreatitis

There’s a lot you can do to reduce your risk of developing pancreatitis. Below, we share some of the most important measures you can take to prevent pancreatitis.

Avoid excessive alcohol use

Alcohol abuse is a well-known risk factor for pancreatitis. Alcoholics are more likely to suffer from chronic pancreatitis, which can lead to nutrient malabsorption and malnutrition.

If you’re a man, limit your alcohol intake to two or fewer drinks per day. If you’re a woman, limit your alcohol consumption to no more than one drink per day.

Don’t smoke

Smoking is a known risk factor for developing pancreatitis. Smoking also carries other major health risks and can increase the likelihood of getting heart disease, certain cancers, and diabetes.

smoking-and-diabetes

Reduce your risk of developing gallstones

If you have a history of gallstones, work with your healthcare providers to learn how to reduce your risk of future gallbladder attacks. 

Knowing the type of gallbladder stones you have is a great way to make the necessary diet and lifestyle modifications to help prevent future attacks.

Eat a healthy diet rich in antioxidants

Plant-based foods like fruits and vegetables contain antioxidants, which help fight inflammation. Omega-3 fatty acids from fatty fish, nuts, and seeds also act to reduce inflammation. Reducing inflammation by increasing your antioxidant and omega-3 intake may help prevent pancreatitis.

Eating a low- to moderate- fat diet may also help reduce your pancreatitis and gallstone risk. 

high blood pressure diet

Be mindful of your added sugar intake

Triglycerides are a form of fat in your blood and having high triglyceride levels are one of the risk factors for pancreatitis. Added sugars can increase your triglycerides. 

You can find added sugars in sugary drinks like soda, sweetened tea, and coffee drinks, fruit-flavored drinks, and energy drinks, to name a few. 

Added sugar is also added to many processed foods, so be sure to check the nutrition facts label to help you keep your added sugar intake in check. Aim to keep your added sugar intake below 50 grams per day (the current recommendation per the 2020-2025 Dietary Guidelines)  – the lower, the better, though.

Conclusion

Pancreatitis can be both acute and chronic, causing painful inflammation of your pancreas. The most common causes of pancreatitis are alcohol abuse and gallstones, but there are other causes as well. 

You can reduce your risk of developing pancreatitis by not abusing alcohol, not smoking, avoiding certain medications that increase your risk of pancreatitis, and working to prevent gallstones if you have a history of gallstone attacks.

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Sources

  1. Drake M, Dodwad SJ, Davis J, Kao LS, Cao Y, Ko TC. Sex-Related Differences of Acute and Chronic Pancreatitis in Adults. J Clin Med. 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7830423/ 
  2. Klochkov A, Kudaravalli P, Lim Y, et al. Alcoholic Pancreatitis. [Updated 2021 Nov 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537191/
  3. Jones MR, Hall OM, Kaye AM, Kaye AD. Drug-induced acute pancreatitis: a review. Ochsner J. 2015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365846/

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