Gallstone pancreatitis is an inflammation of the pancreas that occurs as a result of blockage by a gall bladder stone. (1)
If you think of the gastrointestinal tract in terms of plumbing, the gallbladder, liver, and pancreas have their own drains, also known as “ducts.” All three of these ducts merge into one tube before emptying their contents into the small intestine.
Sometimes, the gallbladder will have a complication where it forms solid granules made of bile salts, commonly known as “gallstones.”
If the gallbladder ejects one of these stones, the stone will travel down its duct and get lodged downstream where the duct of the pancreas drains.
This can cause a blockage in the system, similar to flushing an inappropriate item down the toilet, leading to a clog where all the other plumbing pipes converge.
A blockage where the pancreas drains its contents, will cause an inflammatory response called “pancreatitis.”
The purpose of the pancreas is to aid in digestion. The pancreas produces enzymes that break down proteins, fats, and carbohydrates.
The pancreas also creates hormones known as insulin and glucagon, which are responsible for maintaining blood sugar balance. Thus, the pancreas plays a role in diabetes. When the pancreas cannot create insulin, the affected individual is diagnosed with diabetes mellitus type 1.
Gallstone pancreatitis is certainly a concerning diagnosis. The most common symptom of this condition is abdominal pain.
If someone already knows they have gallstones, the pain may be similar to their usual flare-ups. However, when the pancreas is also involved, the pain may radiate from the abdomen to the back. The pain may also be accompanied by nausea, vomiting, sweating, fever, and chills.
As with most conditions, gallstone pancreatitis can range from very mild to very severe. Most of the gallstones pass into the small intestine, and the symptoms disappear or never appear in the first place.
However, in more serious cases where the stones continue to block the duct, the affected individual can become severely ill and may require intensive care treatment.
Your physician will be able to diagnose this condition through abdominal ultrasound in a majority of cases. Sometimes, a CT scan or MRI will be necessary to find the offending stone.
Blood work will also show to what extent the pancreas is inflamed and if there is any compromise to the body’s organs.
The good news is that gallstone pancreatitis is treatable. If your doctor finds that a gallstone is indeed blocking the drainage of the pancreas, an endoscopic retrograde cholangiopancreatography (ERCP) procedure will be performed. (2)
This procedure sounds very fancy. However, it simply involves inserting a scope down your mouth into the gut to retrieve the stone.
ERCP is essentially a temporary cure. As long as you have your diseased gallbladder that is making gallstones, you will remain at risk for future blockages and subsequent pancreatitis.
The definitive treatment, in the end, is removing the gallbladder in a procedure called a “cholecystectomy.” (3) With the advancement of surgical procedures, this operation can now be performed as an outpatient.
Unfortunately, not much can be done to prevent gallstone pancreatitis. The best you can do is try to maintain a healthy weight as those who are overweight are more likely to get gallstones.
The risks of developing this condition are the exact risks of getting gallstones:
- Female sex
- Age over 40
- Family history of gallstones
- Rapid weight loss
- Some medications
If left untreated, gallstone pancreatitis can cause severe infection (sepsis), organ failure, and even death.
Talk to your doctor if you have ongoing abdominal pain of any sort. An abdominal pain that travels to the right shoulder or the back is likely a sign of gallbladder and/or pancreas inflammation and should be addressed immediately.
If you have these symptoms along with fevers, chills, vomiting, or sweating, go to an emergency room promptly.
Gallstone pancreatitis is actually a gallbladder issue at its core. It can be a temporary and benign condition, or it can progress to serious illness.
Knowing the symptoms and risk factors of gallstones is essential because your doctor can make the diagnosis and recommend early removal of the gallbladder BEFORE it leads to complications such as pancreatitis.
Expert Answers (Q&A)
Answered by Dr. Gautamy Chitiki Dhadham, MBBS (Gastroenterologist)
Does removing the gallbladder cure gallstone pancreatitis?
Removing the gallbladder after acute gallstone pancreatitis prevents future attacks of pancreatitis but does not cure pancreatitis.
The treatment for pancreatitis involves intravenous fluids, pain medications, and fasting for 24 hours, followed by a slow introduction of clear fluids and advancing to “diet as tolerated.”
Can one suffer from pancreatitis without a gallbladder?
Yes, pancreatitis has many causes, such as alcohol abuse, high blood triglyceride levels, autoimmune medications, and viruses.
What dietary changes would you recommend for someone suffering from gallstone pancreatitis?
Gallbladder removal is advised in all patients who had acute gallstone pancreatitis after ruling out other etiologies, and a low-fat diet is usually recommended.
Is surgery the only solution for gallstone pancreatitis?
What are the most common symptoms of gallstone pancreatitis?
The most common symptom is a pain in the stomach area near the umbilicus, radiating to the back. Nausea and vomiting are also common.
Can gallstone pancreatitis cause jaundice?
Yes, jaundice occurs if the stone is in the common bile duct and is obstructing bile flow. In these cases, the patient would first require an endoscopic procedure called endoscopic retrograde cholangiopancreatography (ERCP) to relieve the common bile duct obstruction before gallbladder removal.
How does gallstone pancreatitis affect blood sugar levels?
Mild elevation of blood sugar can be observed in some cases.
What precautionary measures can be taken against gallstone pancreatitis?
Seek medical attention immediately if you experience symptoms of abdominal pain, nausea, and vomiting. A low-fat diet is also recommended.
About Dr. Gautamy Chitiki Dhadham, MBBS: Dr. Dhadham currently works as an advanced gastroenterologist at Bayhealth, doing therapeutic endoscopic procedures including endoscopic ultrasound (EUS), endoscopic retrograde cholangiopancreatography (ERCP), endoscopic mucosal resection (EMR), and endoluminal stent placement.
As a gastroenterologist, Dr. Dhadham treats and diagnoses diseases of the esophagus, stomach, small intestine, colon, pancreas, gallbladder, and liver. She is also trained in comprehensive cancer care and diagnosing and staging gastrointestinal cancers.