The main organ impacted is the pancreas, but since the pancreas plays such an important role in digestion and blood sugar regulation, the effects spill over into other systems too like the digestive system. It’s responsible for releasing enzymes that help break down food, and it also produces hormones like insulin that control glucose levels. When the pancreas gets inflamed over and over again, like through excessive consumption of alcohol, scar tissue builds up. Over time, that scarring can cause the pancreas to stop working the way it should.

That’s when the symptoms start piling up. People with pancreatitis often deal with ongoing abdominal pain, sometimes severe enough to interfere with daily life. They can lose weight without trying, and have digestive issues like abnormal bowel movements because their body isn’t absorbing nutrients properly. It doesn’t just affect digestion; it can also cause diabetes if the insulin producing cells get damaged. To make things even more serious, having pancreatitis increases the risk of pancreatic cancer.

For this project, I want to focus on how the disease progresses and how it changes the body over time. I’m especially interested in how the scarring affects digestion, why nutrient absorption breaks down, and how that connects to weight loss and long-term complications. I think learning more about it will give me a better understanding of not just the pancreas, but how one small organ can have such a huge impact on a person's overall health. Hopefully this research will also help me resolve some personal confusion over the untimely death of a loved one and understand how and why it seemed to come out of nowhere and take them so quickly despite it being a long term condition.

References:

Mayo Clinic Staff. (2023, September 23). Pancreatitis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/pancreatitis/symptoms-causes/syc-20360227

National Institute of Diabetes and Digestive and Kidney Diseases. (2017, November). Symptoms & Causes of Pancreatitis. National Institutes of Health. https://www.niddk.nih.gov/health-information/digestive-diseases/pancreatitis/symptoms-causes

When diagnosing a patient, healthcare professionals will look for both signs and symptoms. The signs are objective findings observed or measured by the clinician during examination, where as the symptoms are subjective experiences described from the patient's perspective. The collected data is combined to most accurately determine the patient's condition.

For pancreatitis, the symptoms tend to be more prominent than the signs, because the patient becomes immediately aware of them, such as upper abdominal pain, digestive issues like nausea, vomiting, loss of appetite, and the pain worsening after eating. However, because the digestive system involves multiple interconnected organs, these symptoms alone could be the cause of many other gastrointestinal conditions. That is where examination of the objective signs becomes crucial for isolating the true condition and preventing a misdiagnosis of an overlapping one. Therefore, when these symptoms are accompanied by fever, jaundice, and the measurement of elevated pancreatic enzyme levels they strongly support a diagnosis of pancreatitis.

Having witnessed this condition secondhand with a family member, I am familiar with the signs and symptoms of pancreatitis. It was deeply saddening when we couldn't do the things we used to, like going on hikes or enjoying delicious food together. It was especially jarring to see their skin, and the sclera of their eyes transition to a glowing yellow from jaundice, and to watch them become weak due to weight loss. In retrospect, it means so much to me, more than they will ever know, how they tried their best to maintain these shared experiences even when it caused them so much pain.

To add credibility to my statements, I have researched reputable medical sources that confirmed my personal observations. The primary symptom of pancreatitis is severe upper abdominal pain that may even spread to the back. Another common symptom is increased pain after eating leading to nausea and loss of appetite (National Institute of Diabetes and Digestive and Kidney Diseases, 2017). Clinicians may observe signs such as abdominal tenderness, fever, jaundice, tachycardia, and elevated pancreatic enzyme levels (Makary & Seif, 2025).

References:

Makary, M. A., & Seif, M. (2025). Acute pancreatitis. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482468/

National Institute of Diabetes and Digestive and Kidney Diseases. (2017, November). Symptoms & causes of pancreatitis. U.S. Department of Health and Human Services. https://www.niddk.nih.gov/health-information/digestive-diseases/pancreatitis/symptoms-causes

This inflammatory condition is showing up more and more in hospitals. According to the National Institute of Diabetes and Digestive and Kidney Diseases, acute pancreatitis is the #1 cause of hospital stays for gastrointestinal disorders in America, with approximately 275,000 annual cases. Chronic cases are less common with 86,000, but more are severe and require longer hospitalization (National Institute of Diabetes and Digestive and Kidney Diseases [NIDDK], 2024). Around the world, including Europe and Asia, cases keep climbing from around 1.73 million cases in 1990 to 2.75 million in 2021, with the death count nearly doubling from 68,000 to 122,000 (Li et al., 2024). The rising numbers in connection to pancreatitis should be a wake up call. People really need to know how much of this can be prevented.

Pancreatitis is normally classified as either acute or chronic, but when excessive drinking, 4-5 alcoholic beverages a day over a 5 year span, is introduced to the body, it presents itself in a third form: alcoholic pancreatitis (Klochkov et al., 2023). Alcohol causes 17–25% of acute cases, second only to gallstones (Klochkov et al., 2023). Yadav et al. (2016) add that smoking, high-fat diets, and genetics can magnify pancreatic damage. Their findings were even more staggering when it came to the chronic form of this disease. Alcohol is the leading cause of chronic pancreatitis, cause about half the cases in the United States and as high as 80–90% globally in earlier studies (Yadav, Rebours, & Machicado, 2016). According to the NIDDK (2024), gallstones, obesity, and elevated triglycerides can overwhelm the pancreatic ducts and cause acute flare-ups. That’s worrying in places where alcohol and processed foods are everywhere and life is mostly sitting down. At least it’s not contagious, but the habits that cause it have become too normal. Education and moderation could help fix that.

Personally, I don't think we should outright ban or prohibit the use of alcohol, fatty foods, or smoking. There is a time and place to enjoy these things, but it shouldn't be every day. By intentionally planning our meals, we can avoid indulging in junk food out of convenience. I sympathize with people who struggle with alcoholic and nicotine-based substances and highly recommend staying away from it entirely if it opens the door to addiction. These should be saved for special occasions.

References:

Klochkov, A., Kudaravalli, P., Lim, Y., & Sun, Y. (2023, May 16). Alcoholic pancreatitis. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537191/

Li, T., Qin, C., Zhao, B., Li, Z., Zhao, Y., Lin, C., & Wang, W. (2024). Global and regional burden of pancreatitis: Epidemiological trends, risk factors, and projections to 2050 from the Global Burden of Disease Study 2021. BMC Gastroenterology, 24, 398. https://doi.org/10.1186/s12876-024-03481-8

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2024, May 20). Pancreatitis: Definition & facts. U.S. Department of Health and Human Services. https://www.niddk.nih.gov/health-information/digestive-diseases/pancreatitis/definition-facts

Yadav, D., Rebours, V., & Machicado, J. D. (2016). Epidemiology of chronic pancreatitis. Pancreapedia: The Exocrine Pancreas Knowledge Base. https://pancreapedia.org/reviews/epidemiology-of-chronic-pancreatitis

To distinguish possible etiologies of acute pancreatitis, investigation mainly includes laboratory evaluation of pancreatic enzymes, amylase and lipase levels, measurements of triglycerides and calcium levels for hypertriglyceridemia or hypercalcemia, and liver tests which would indicate gallstones (Vege & DiMagno, 2024). Imaging techniques such as ultrasound, CT scans, and MRI/MRCP of the abdominal region are used to visualize the severity of inflammation classified as mild, moderate, or severe. These can also detect complications like necrosis and ductal abnormalities (Makary & Seif, 2025).

Diagnosis of chronic pancreatitis uses similar methods; however, it primarily focuses on progression of the disease and the pancreas’s long-term structural changes, like calcifications and ductal dilation, with no universal classification, with the inclusion of an endoscopic ultrasound (EUS) to check for early fibrosis (Yadav et al., 2016). Lipase and amylase levels may show up as normal, but the pancreas fails to produce enzymes (Yadav et al., 2016). Unlike acute pancreatitis, functional testing is essential for a chronic diagnosis, which involves fecal elastase to detect exocrine insufficiency and blood glucose tests for detecting endocrine failure (Yadav et al., 2016). Low vitamin (A, D, E, and K) levels are evidence of malabsorption and can lead to malnutrition (Ashraf et al., 2021).

References:

Ashraf, H., Colombo, J. P., Marcucci, V., Rhoton, J., & Olowoyo, O. (2021). A clinical overview of acute and chronic pancreatitis: The medical and surgical management. Cureus, 13(11), Article e19764. https://doi.org/10.7759/cureus.19764

Makary, M. A., & Seif, M. (2025). Acute pancreatitis. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482468/

Song, Y., Zhang, Z., & Chen, L. (2024). Recent treatment strategies for acute pancreatitis. Journal of Clinical Medicine, 13(4), 978. https://doi.org/10.3390/jcm13040978

Vege, S. S., & DiMagno, M. J. (2024). Acute pancreatitis. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482468/

Yadav, D., Rebours, V., & Machicado, J. D. (2016). Epidemiology of chronic pancreatitis. Pancreapedia: The Exocrine Pancreas Knowledge Base. https://pancreapedia.org/reviews/epidemiology-of-chronic-pancreatitis

Obviously, both forms are painful and require analgesics for alleviating abdominal pain. The type of painkillers differ from short-term opioids for acute conditions to long-term regimens of nonsteroidal anti-inflammatory drugs (NSAIDs), sometimes even nerve blockers, for chronic conditions (Yadav et al., 2016). Pain tends to be the ultimate motivator, and once the underlying cause is determined, it is essential to stop whatever is triggering the inflammation to prevent further complications (Ashraf et al., 2021). There are a number of lifestyle changes that can be addressed: total alcohol cessation is the most important, smoking cessation, incorporating a low-fat, healthy diet with small portion sizes while avoiding fried foods and refined carbs like sugar, staying hydrated, and discontinuing use of medications that can elevate triglycerides (Ashraf et al., 2021).

Besides alcohol, gallstones are another one of the leading causes of acute pancreatitis that block the pancreatic duct but are much less common in chronic forms (Vege & DiMagno, 2024). They are treated with aggressive IV fluids like Lactated Ringer’s and enteral nutrition. Hypertriglyceridemia, caused by similar etiologies, can increase the risk of acute pancreatitis and is often treated by IV insulin infusion that lowers triglycerides (Makary & Seif, 2025). If the case is more severe, they may resort to plasmapheresis by replacing plasma high in triglycerides with clean plasma (Song et al., 2024). Some experimental research is exploring anti-inflammatory therapies to target early inflammation in acute pancreatitis (Song et al., 2024). In some cases, when obstruction occurs, endoscopic retrograde cholangiopancreatography (ERCP) is performed to remove gallstones in acute cases, and the same intervention is used to remove calcium stones in chronic cases (Vege & DiMagno, 2024). There have also been recent advances like the step-up approach that involves staged drainage and endoscopic necrosectomy as an alternative to open surgery for acute necrotizing pancreatitis (Song et al., 2024).

The biggest challenge for chronic pancreatitis is pain management, mostly due to nerve damage and fibrosis, where the pancreas heals itself with thick scar tissue after repeated damage or long-term inflammation (Yadav et al., 2016). This alone can obstruct ducts and disrupt exocrine and endocrine processes, causing further abdominal pain (Ashraf et al., 2021). One of the most important treatments for chronic cases is pancreatic enzyme replacement therapy (PERT) that takes over digestive enzyme production, helps absorption of vitamins (A, D, E, and K), and decreases pancreatic stimulation (Ashraf et al., 2021). Research is also exploring regenerative and stem-cell–based therapies aimed at reversing fibrosis and restoring pancreatic function in chronic pancreatitis, though these approaches are still in early investigation (Ashraf et al., 2021). On the endocrine side, most patients require insulin therapy, modifications to their diet, and frequent monitoring of blood glucose levels because it can lead to type 3c diabetes (Yadav et al., 2016).

Before surgery is considered, other interventions besides ERCP may include pancreatic duct stenting and dilation of strictures (Ashraf et al., 2021). Surgery becomes necessary if these interventions fail or the duct is severely obstructed (Yadav et al., 2016). They may perform a pancreatojejunostomy (Puestow procedure) for drainage, a distal pancreatectomy for partial resections, Frey or Beger procedures for resection/drainage hybrids, or a total pancreatectomy with islet autotransplantation (TPIAT) for severe cases (Ashraf et al., 2021). These surgeries are usually considered for pain relief and to reduce inflammation flare-ups, of course.

References:

Ashraf, H., Colombo, J. P., Marcucci, V., Rhoton, J., & Olowoyo, O. (2021). A clinical overview of acute and chronic pancreatitis: The medical and surgical management. Cureus, 13(11), Article e19764. https://doi.org/10.7759/cureus.19764

Makary, M. A., & Seif, M. (2025). Acute pancreatitis. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482468/

Song, Y., Zhang, Z., & Chen, L. (2024). Recent treatment strategies for acute pancreatitis. Journal of Clinical Medicine, 13(4), 978. https://doi.org/10.3390/jcm13040978

Vege, S. S., & DiMagno, M. J. (2024). Acute pancreatitis. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482468/

Yadav, D., Rebours, V., & Machicado, J. D. (2016). Epidemiology of chronic pancreatitis. Pancreapedia: The Exocrine Pancreas Knowledge Base. https://pancreapedia.org/reviews/epidemiology-of-chronic-pancreatitis