Gallstone pancreatitis is a painful and potentially life threatening condition where a gallstone blocks a person’s pancreatic duct. This causes digestive juices to back up and damages the pancreas.

Acute (short-term) pancreatitis is the most common cause of gastrointestinal-related hospitalizations in the United States. Gallstones cause around 35–40% of these.

This article discusses gallstone pancreatitis, its causes, symptoms, diagnosis, treatment, and potential complications. We also explore what a person can do to help prevent it and when to contact a doctor.

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Gallstone pancreatitis is the primary cause of acute pancreatitis. This is where the pancreas becomes inflamed in response to injury.

Gallstone pancreatitis occurs when gallstones are dislodged from the gallbladder and get stuck in the pancreatic duct. This causes digestive juices to accumulate in the pancreas, where the organ may then begin “digesting” itself.

Gallstones usually form in the gallbladder, which stores and releases bile to help with digestion. Most gallstones occur when substances in bile, such as cholesterol, harden.

The pancreas is a small organ that makes digestive juices called enzymes. These help break down fat, carbohydrates, and proteins.

Digestive juices flow down a tube (pancreatic duct), joined by another duct (common bile duct) where the bile from the gallbladder passes through. These tubes join and drain fluids into the first section of the intestine (duodenum).

Gallstones may leave the gallbladder, pass through the bile duct, and get stuck in the pancreatic duct or near the opening of the small intestine. This prevents the digestive juices from draining, causing fluids to back up the pancreas.

An infographic showing the different parts of the pancreas, bile duct and gallstonesShare on Pinterest
Gallstones can block your pancreatic duct, causing inflammation of the pancreas resulting in pancreatitis. Yaja Mulcare

The most common symptom of gallstone pancreatitis is severe, sharp pain, often located in the upper part of the abdomen (epigastric region).

A person may also experience other symptoms:

According to 2013 guidelines from the American College of Gastroenterology (ACG), the diagnosis of acute pancreatitis should include at least two of the following criteria:

  • abdominal pain consistent with acute pancreatitis
  • serum lipase or lipase levels, an enzyme found in the pancreas, three times greater than the upper limit of the usual range
  • abdominal imaging shows findings of acute pancreatitis

Doctors who suspect acute pancreatitis will request specific tests:

The ACG guidelines also state that a person does not need a CT scan or MRI unless the diagnosis remains unclear or if symptoms do not ease 2–3 days after admission to the hospital.

The outlook depends on the severity of the condition. Gallstone pancreatitis has a mortality rate of 1–2% and a much higher risk in severe cases.

Once a doctor determines that a person has gallstone pancreatitis, the first and most crucial early treatment is to provide fluids to reduce the body’s inflammation. More often than not, this is enough for the stone to pass.

Healthcare professionals will also provide medicines to manage other symptoms such as pain, nausea, and vomiting.

People with mild gallstone pancreatitis may eat and feel relief within a few days, while those with severe gallstone pancreatitis may need to eat through a tube for a longer time.

Early cholecystectomy, or removal of the gallbladder, is recommended in people with gallstone pancreatitis. A surgeon can do this through endoscopy or surgery.

Undergoing cholecystectomy within 48 hours of symptoms appearing can significantly shorten a person’s hospital stay compared with waiting until pain resolves, according to research from 2014.

Most people recover from the condition without experiencing problems. However, those with more severe pancreatitis may develop serious complications.

Cholangitis

Left untreated, the blockage can cause pancreatic fluid to collect and back up to the pancreas, liver, and gallbladder, leading to severe inflammation.

Jaundice

The obstruction may also cause jaundice, which causes yellowing of the skin and eyes. This occurs when there is too much bilirubin in the blood.

Pancreatic necrosis

Pancreatic necrosis is a serious complication of acute pancreatitis, which makes up around 27% of morbidity and mortality rates caused by pancreatitis.

This occurs when part of the pancreas dies because of inflammation or injury. If these dead tissues become infected, it may cause more serious systemic complications such as a blood infection (sepsis).

Pseudocysts

Fluid sacs, called pseudocysts, can develop on the surface of the pancreas. This may cause feelings of indigestion, bloating, and pain. They usually resolve on their own, but may sometimes need to be drained.

They can also become infected, leading to further complications.

Chronic pancreatitis

A person who has acute pancreatitis repeatedly may eventually experience permanent damage to their pancreas, called chronic pancreatitis. This is a long-term condition that does not improve and will ultimately impair the functions of the pancreas, including food digestion and insulin production.

Systemic complications

Aside from sepsis, untreated gallstone pancreatitis may lead to a host of complications affecting the body, including:

Preventing gallstone pancreatitis is challenging because it is difficult to stop gallstones from developing. However, individuals can take steps to reduce their risk of gallstones.

Eating a balanced diet with high fiber, low fat, and low sugar may help prevent gallstone formation.

Maintaining a moderate weight and managing diabetes in people with the condition can also reduce their risk of pancreatitis.

Stopping smoking and reducing alcohol intake can also help prevent gallstones from developing. People who drink have four times the risk of developing acute pancreatitis.

A 2019 review also found a dose-response relationship between tobacco smoking and acute and chronic pancreatitis, where increased cigarette intake and pack-years increase a person’s pancreatitis risk.

There are clear warning signs that indicate if a person has gallstone pancreatitis. A person who experiences severe, squeezing, or sharp pain in the upper abdomen should immediately seek medical help.

Gallstone pancreatitis is a common complication of gallstone formation. It is a painful and potentially life threatening condition that requires immediate medical attention.

While mild cases can resolve by themselves, more severe cases require surgery to help prevent complications. A person who suspects they have the condition should immediately visit the hospital for help.