The main symptom of sudden (acute) pancreatitis is sudden moderate to severe pain in the upper area of the belly (abdomen). Pain may also spread to your back.

Sometimes the pain is mild. But the pain may feel as though it bores through the belly to the back. Sitting up or leaning forward sometimes eases the pain. Other symptoms of an attack of pancreatitis are:

• Nausea and vomiting.
• Fever.
• Fast heart rate.
• Sweating.
• Yellowing of the skin or the whites of the eyes (jaundice).
• Shock.

Long-term (chronic) pancreatitis also causes pain in the upper belly.

Other conditions that have similar symptoms include bowel obstruction, appendicitis, cholecystitis, peptic ulcer disease, and diverticulitis.

Normally, the structure of the pancreas and the pancreatic duct prevent digestive enzymes from damaging the pancreas. But certain conditions can occur that cause damage and pancreatitis.

Acute pancreatitis

Most attacks of pancreatitis are caused by gallstones that block the flow of pancreatic enzymes or by drinking too much alcohol. Sudden (acute) pancreatitis may happen after a drinking binge or after many episodes of heavy drinking.

Other causes of acute pancreatitis are:

• Infections, including mumps.
• Some medicines. These include certain antibiotics, steroids, and blood pressure medicines.
• Injury.
• High triglycerides.

Sometimes the cause isn't known.

Chronic pancreatitis

Drinking too much alcohol is the most common cause of ongoing (chronic) pancreatitis.

Other causes of chronic pancreatitis include cystic fibrosis and a blockage in the pancreas. Chronic pancreatitis may run in families. And smoking cigarettes seems to increase the risk for this disease. In about 1 out of 4 cases, doctors aren't sure what causes it.

Experts don't know how alcohol irritates the pancreas. Most believe that alcohol may cause enzymes to back up into the pancreas. Or it may change the chemistry of the enzymes. This can cause them to inflame the pancreas.

You can lower your risk for chronic pancreatitis by avoiding alcohol. Alcohol use is the most common cause of chronic pancreatitis. It is very important that you not drink any alcohol. If you drink even small amounts, it can cause severe pain and problems. If you drink large amounts of alcohol when you have chronic pancreatitis, it can shorten your life.

You can't fully prevent chronic pancreatitis caused by gallstones. But you may be able to lower your risk for gallstones. To do this, it's important to stay at a weight that's healthy for you, be active, and eat healthy low-fat foods.

If you smoke, you may lower your risk for chronic pancreatitis if you quit.

If your doctor thinks that you have chronic pancreatitis, they will ask questions about your symptoms and history of pancreatitis and do a physical exam. You may have blood tests to see if your levels of pancreatic enzymes are higher than normal.

Your doctor may also do a CT scan of your belly to look for scarring and other signs of damage of the pancreas. Sometimes a special MRI test called magnetic resonance cholangiopancreatography (MRCP) is used.

Treatment of acute pancreatitis usually takes place in the hospital. It focuses on taking care of pain and supporting your body while your pancreas heals. In severe cases, treatment may occur in an intensive care unit to support breathing, treat serious infections, or help raise very low blood pressure.

If a gallstone is causing the problem, the gallstone may need to be removed. This is done during a procedure called ERCP. The doctor puts a scope in your mouth and moves it gently through the stomach and into the ducts from the pancreas and gallbladder. The doctor is then able to see a stone and remove it.

Sometimes the gallbladder, which makes gallstones, needs to be removed by surgery.

People with pancreatitis often need a lot of fluid to help support their other organs and their blood pressure. They get fluids through a vein (intravenous, or I.V.).

If you have chronic pancreatitis caused by alcohol use, you'll need to quit drinking to reduce severe pain and other problems that can happen (complications). If you drink large amounts of alcohol when you have chronic pancreatitis, it can shorten your life.

It's not clear how your diet might affect pancreatitis. But doctors recommend that you eat low-fat foods and stay at a healthy weight.