Pancreatic Disease

The pancreas is an organ behind the stomach that helps with:

• Digestion (by producing enzymes that break down food)
• Blood sugar control (by producing hormones such as insulin)

“Pancreatic diseases” is a broad term covering conditions that affect pancreatic function. Some problems are sudden and severe (such as acute pancreatitis), while others develop gradually (such as chronic pancreatitis or pancreatic exocrine insufficiency). Because symptoms can overlap with other digestive conditions, assessment is important to confirm the cause and guide treatment.

At the Royal Buckinghamshire Hospital, we provide consultant-led assessment and investigation to identify the cause of pancreatic symptoms and recommend an appropriate treatment plan.

---

Types of pancreatic disease

Common pancreatic conditions include:

• Acute pancreatitis
  Sudden inflammation of the pancreas that can cause severe abdominal pain and requires urgent medical assessment.
• Chronic pancreatitis
  Long-term inflammation leading to scarring, ongoing pain, and reduced digestive function.
• Pancreatic exocrine insufficiency (PEI)
  The pancreas does not produce enough digestive enzymes, leading to malabsorption and weight loss.
• Pancreatic cysts
  Fluid-filled areas in or around the pancreas. Many are benign but may need monitoring.
• Pancreatic tumours (benign or malignant)
  Less common, but important to investigate if there are red flag symptoms.
• Diabetes related to pancreatic disease
  Some pancreatic conditions affect insulin production and blood sugar control.

---

Common causes and risk factors

Causes vary depending on the condition, but can include:

• Gallstones (a common trigger for acute pancreatitis)
• Alcohol (a common contributor to chronic pancreatitis)
• High triglycerides (raised blood fats) in some cases
• Certain medications (rarely)
• Smoking (increases risk of chronic pancreatitis and pancreatic cancer)
• Previous pancreatic inflammation
• Genetic factors (in some people)
• Autoimmune pancreatitis (less common)
• Structural issues affecting pancreatic ducts

---

Symptoms of pancreatic disease

Symptoms depend on the underlying condition. Common symptoms include:

Pain and digestive symptoms

• Upper abdominal pain (may radiate to the back)
• Pain that may worsen after eating
• Nausea and vomiting
• Bloating and indigestion symptoms
• Loss of appetite

Signs of reduced digestive enzymes (PEI)

• Weight loss despite normal intake
• Pale, greasy, floating stools (steatorrhoea)
• Diarrhoea or urgent bowel movements
• Excess wind
• Nutritional deficiencies (fat-soluble vitamins)

Signs that require prompt assessment

• Jaundice (yellowing of skin/eyes), dark urine, pale stools
• Persistent, worsening upper abdominal pain
• Unexplained weight loss
• New-onset diabetes (especially with weight loss) in some cases

---

Diagnosis at Royal Buckinghamshire Hospital

Assessment is tailored to symptoms and may include:

• Detailed history (pain pattern, alcohol intake, gallstone history, weight change, bowel symptoms)
• Examination (including abdominal tenderness and signs of jaundice)
• Blood tests, which may include:
  • Pancreatic enzymes (e.g., amylase/lipase) if pancreatitis is suspected
  • Liver tests (especially if gallstones/jaundice are present)
  • Inflammation markers and kidney function
  • Blood fats (triglycerides) and glucose/HbA1c
• Stool tests in selected cases (to assess pancreatic enzyme output and malabsorption)
• Imaging as appropriate, such as:
  • Ultrasound (often used to look for gallstones/bile duct issues)
  • CT scan (common for pancreatitis assessment and complications)
  • MRI/MRCP (to assess pancreatic/bile ducts)
  • Endoscopic tests where clinically appropriate

You will receive a clear explanation of findings and what the results mean for treatment options.

---

Treatment & management

Treatment depends on the diagnosis and severity.

Acute pancreatitis (urgent condition)

Acute pancreatitis often requires hospital-based care. Treatment commonly focuses on:

• Pain control
• Intravenous fluids and monitoring
• Treating the trigger (for example gallstone-related pathways)
• Managing complications if they occur

Chronic pancreatitis

Management may include:

• Pain management and flare-up planning
• Dietary support and nutrition optimisation
• Avoiding alcohol and stopping smoking
• Treating complications (such as diabetes or bile duct narrowing) where present

Pancreatic exocrine insufficiency (PEI)

Treatment may include:

• Pancreatic enzyme replacement therapy (PERT) with meals
• Dietitian support to maintain weight and nutrition
• Monitoring and replacing vitamin/mineral deficiencies where needed

Pancreatic cysts or tumours

Management varies depending on imaging and risk features and may include:

• Monitoring with follow-up scans
• Further investigation if there are concerning features
• Referral into specialist surgical/oncology pathways where required

---

When to seek urgent help

Seek urgent medical advice (same day/emergency care) if you develop:

• Severe, worsening upper abdominal pain (especially with vomiting)
• Fever, confusion, fainting, or severe dehydration
• Jaundice, especially with abdominal pain or fever
• Vomiting blood or passing black stools
• Sudden worsening symptoms in someone with known pancreatitis

---

If you have persistent upper abdominal pain, unexplained weight loss, greasy stools, or symptoms that suggest pancreatic disease, contact Royal Buckinghamshire Hospital for assessment and guidance. There is no need to be registered with the hospital, or live locally.

If you have insurance which covers consultations, we can in most cases invoice the insurer directly. Where you are paying directly, any costs will always be discussed.