The pancreas is the organ that is found behind the stomach. It is essential in the digestion of food (by secreting digestive juices) as well as the production of hormones like insulin, which is important for control of blood sugar level. What is pancreatitis? Pancreatitis refers to the inflammation of the pancreas. In other words, the pancreas becomes swollen, causing pain. When this happens acutely, digestive enzymes from the pancreas attack the tissues that produces them, leading to tissue damage, bleeding, infection or even death. In chronic cases, this can lead to malabsorption of food or failure in production of hormone by the pancreas. There are two stages of pancreatitis: Acute pancreatitis: This occurs suddenly and commonly due to gallstones or alcohol abuse. When gallstones pass through the bile duct, they may cause obstruction in the flow of pancreatic digestive juices, thereby damaging the pancreas. In the case of alcohol, the amount required to cause inflammation varies from person to person and can occur from within a few hours to a few days after drinking. Other less common causes of this condition include excessive level of fat in the blood, certain infection such as mumps, intake of certain drugs / medications, hereditary causes or related to certain surgery. Chronic pancreatitis: This is usually preceded by acute pancreatitis. The condition becomes chronic after recurrent inflammation and when the pancreas becomes scarred. What are the symptoms of pancreatitis? At the time of presentation, acute pancreatitis may be accompanied by: Gradual or sudden, severe pain in the center of the upper abdomen which may radiate to the back. This pain may be triggered by food intake initially, but later progresses to a persistent pain. Nausea and vomiting Jaundice, or yellow discoloration of the skin and / or eyes Weight loss Infection which may lead to life-threatening state of shock Symptoms of diabetes mellitus, e.g. increased frequency of passing urine, etc Cancer, in people with background of chronic pancreatitis. What should I do if I think I have pancreatitis? If your abdominal pain is severe and lasts more than 20 minutes, consult your doctor early or go to the emergency dept. If the weight loss is unexplained and lasts more than a few weeks, consult a doctor early too. This can be a warning sign of cancer of the pancreas. Investigations Blood tests including pancreatic enzymes, serum fat (triglyceride) level, markers of inflammation and liver function tests Radiological imaging including abdominal Xray, abdominal ultrasound as well as computerised tomography (CT) scan Endoscopic procedure called endoscopic retrograde cholangio-pancreaticography (ERCP) can be of both diagnostic as well as therapeutic purpose. Treatment The initial management is aimed towards stabilising the patient's condition, and satisfy his / her metabolic and nutritional needs. Painkillers can be prescribed for significant pain. Antibiotics are given for associated infection. Occasionally, changes in dietary regime and pancreatic enzyme supplements are required. If the cause is due to an obstructing gallstone in the bile duct, this can be confirmed and removed by endoscopic retrograde cholangio-pancreaticography (ERCP). With the aid of fluoroscopic xray, removal of the obstructing gallstones or drainage of bile and/or pancreatic juices can be carried out. The gallbladder (source of gallstones), in this circumstances, is usually recommended to be removed by surgery at a later date.