Acute pancreatitis: sudden severe abdominal pain
When the digestive gland starts digesting itself
Dr. Marc Delaunay
Gastroenterologist
In simple terms
The two main causes, why the pain goes through to the back, and what hospital treatment involves.
What it is, in plain words
The pancreas makes powerful digestive enzymes that are normally activated only in the intestine. In acute pancreatitis they are activated too early, inside the gland, and cause intense inflammation. Most attacks are mild and settle in a few days, but a minority become severe and affect other organs.
Signs to look out for
- Severe pain in the upper abdomen, boring straight through to the back
- Pain often eased by sitting forward and worsened by lying flat
- Nausea and repeated vomiting that does not relieve the pain
- Bloated, tender abdomen and fever
- Jaundice when a gallstone blocks the bile duct
Why it happens
Gallstones and heavy alcohol use cause about eight in ten attacks. Others follow very high blood triglycerides, certain medicines, high calcium, abdominal injury, or endoscopic procedures on the bile duct.
How doctors confirm it
Blood amylase or lipase at least three times the upper limit, together with typical pain, confirms it. Ultrasound looks for gallstones, and CT after a couple of days assesses severity and complications.
Treatments and solutions
- Hospital admission with generous intravenous fluids in the first 24 hours, the single most important treatment
- Effective pain relief, including opioids when needed
- Early feeding by mouth as soon as it is tolerated, rather than prolonged starvation
- Urgent endoscopic removal of a stone blocking the bile duct when there is infection or jaundice
- Gallbladder removal during the same admission for stone-related cases, to prevent recurrence
Living with it day to day
After recovery, address the cause: complete alcohol abstinence, gallbladder surgery, triglyceride and diabetes control. Repeated attacks can lead to chronic pancreatitis with diabetes and poor fat absorption.
When to seek medical help
Go to hospital immediately for severe unremitting abdominal pain with vomiting, fever, or a rapid pulse.
This article explains general health information in simple language. It does not replace advice from your own doctor.
The words explained
Medical terms used above, in everyday language.
- Chronic
- A problem that lasts a long time, usually more than three months, and often comes back.
- Acute
- Something that starts suddenly and lasts a short time.
- Inflammation
- The body's reaction to injury or irritation: redness, swelling, heat or pain.
- Prevention
- Steps taken before a problem starts, to make it less likely.
When should you see a doctor?
- Your symptoms last more than a few weeks or keep coming back.
- They get worse quickly, or stop you doing everyday things.
- You notice sudden pain, breathing trouble, fainting or bleeding — seek urgent care.
- You already take medication and want to change anything about it.
This article explains general health information. It does not replace advice from your own doctor.
Frequently asked questions
- What is Acute pancreatitis: sudden severe abdominal pain?
- The two main causes, why the pain goes through to the back, and what hospital treatment involves.
- What are the main symptoms or signs of Acute pancreatitis: sudden severe abdominal pain?
- Common signs vary from person to person. The article above lists the symptoms to watch for, how they progress, and when they need medical attention.
- When should you see a doctor for Acute pancreatitis: sudden severe abdominal pain?
- See a doctor if symptoms last more than a few weeks, get worse quickly, stop you doing everyday things, or if you notice sudden pain, breathing trouble, fainting or bleeding.
Related health topics
Neurology
Stroke: Every Minute Counts to Save the Brain
Falling face, weak arm, difficulty speaking: recognizing the signs of a stroke and calling 911 immediately can save lives and limit sequelae.
Cancer & Oncology
Pancreatic cancer: a diagnostic challenge
Warning signs, FOLFIRINOX chemotherapy, Whipple surgery: progress against a tough cancer.
Pulmonology
Pulmonary embolism: when a clot reaches the lungs
Recognising the symptoms, understanding the tests, and knowing what treatment and follow-up involve.
Digestive Health
Appendicitis: the pain that moves to the right
How the pain typically migrates, why children and older adults are harder to diagnose, and what surgery involves.
Eye Health
Acute angle-closure glaucoma: a red painful eye emergency
How drainage suddenly blocks, the classic symptoms, and why laser treatment protects the other eye too.
Infectious Diseases
Meningitis: the signs that must never be ignored
How viral and bacterial meningitis differ, the tests that decide, and the prevention available.