Medical notice. This page is for information only. It is not medical advice. Chronic pancreatitis is diagnosed and treated by clinicians. Sudden, severe abdominal pain still needs urgent care — call 112. Full notice: Medical disclaimer.
Chronic pancreatitis is a long-term condition in which the pancreas is inflamed, scarred, and often painful. The gland does not heal. Damage can worsen over time and become permanent. There is currently no cure, but there are treatments for the problems it causes. (NHS, last reviewed 20 October 2025; NIDDK)
It is different from acute pancreatitis, which is a sudden attack. Repeated acute attacks can lead to chronic disease. (NHS; NIDDK)
The HaPanEU guidelines from United European Gastroenterology describe chronic pancreatitis as a continuing inflammatory disorder that replaces pancreatic tissue with fibrosis, so that exocrine function (digestive enzymes) and/or endocrine function (insulin) can fail. Pain, pancreatic exocrine insufficiency (PEI) with malnutrition, diabetes, and a higher risk of pancreatic cancer are the main long-term concerns. (Löhr et al., 2017)
Symptoms
The main symptom is pain in the abdomen. NHS says the pain may be in the upper tummy (just below the ribs), on one side, or throughout the tummy; constant or coming and going; severe or a dull ache; better when sitting and leaning forward; and worse after eating. (NHS)
Other symptoms can include:
- nausea or vomiting
- diarrhoea
- very smelly stools that float and are hard to flush (steatorrhoea — fat that is not absorbed)
- bloating or passing a lot of wind
- thirst or needing to pee a lot (a possible sign of diabetes)
- losing weight without trying
(NHS; Mayo Clinic; NIDDK)
Some people have little or no pain and only develop symptoms once complications appear. In others, pain may lessen as the disease becomes very advanced — that is not a reason to delay care. (NIDDK; Mayo Clinic)
Symptoms can resemble irritable bowel syndrome or gallstones. See a GP if you think you might have chronic pancreatitis. Ask for urgent care if you get sudden, severe tummy pain — that could be an acute attack on top of chronic disease. (NHS)
Causes
The most common cause is drinking alcohol. Repeated acute attacks from alcohol can scar the pancreas permanently. (NHS)
Chronic pancreatitis can also be linked to:
- smoking
- genes, including the gene that causes cystic fibrosis (the most common cause in children, according to NHS)
- the immune system attacking the pancreas (autoimmune pancreatitis)
- the pancreas not developing properly before birth
- some medicines
- blockage in the pancreatic duct
- high blood fats or high blood calcium
- damage from repeated acute pancreatitis of any cause
- no clear cause (idiopathic) — ACG notes the cause is unknown in nearly a third of patients despite extensive evaluation
(NHS; Mayo Clinic; NIDDK; ACG)
NHS notes that chronic pancreatitis mainly affects adults and is more common in people who drink or smoke a lot. (NHS)
Watch
Chronic pancreatitis animation (National Pancreas Foundation)
Diagnosis
There is no single test. A doctor may need to rule out other causes first. A GP may examine your tummy, check for jaundice, weigh you, arrange blood tests or a stool test (including faecal elastase in many European pathways), and ask about family history. A specialist may arrange CT, ultrasound, MRI/MRCP, gastroscopy, or endoscopic ultrasound. (NHS; NIDDK; Mayo Clinic)
HaPanEU reviews tests of pancreatic function, including faecal elastase-1 (FE-1), and emphasises diagnosing pancreatic exocrine insufficiency. (HaPanEU)
Diagnosing chronic pancreatitis can be hard in the early stages. (NIDDK)
Problems it can cause
Scarring can lead to:
- poor absorption of nutrients, with weight loss and weaker bones (osteoporosis)
- type 3c diabetes — the pancreas does not make enough insulin
- cysts that can become infected, bleed, or press on nearby organs
- blockage of the pancreatic duct or bile ducts (pain, gallbladder inflammation)
- a higher risk of pancreatic cancer
- ongoing pain and a heavy effect on daily life
NHS is clear that the condition can affect how long you live, though this differs from person to person, and that most people live with it for many years. Damage usually gets worse over time and cannot be reversed — but not drinking alcohol and not smoking can help slow it and reduce other problems. (NHS)
Treatment — managing, not curing
You will often be supported by a GP, a gastroenterologist, specialist nurses, and a dietitian. HaPanEU was written so that this kind of care is more consistent across Europe. (NHS; HaPanEU)
Treatment may include:
Pain relief. Medicines first, using the lowest effective step. Endoscopy or surgery may help if a duct is blocked by a stricture or stone. Nerve-block injections are sometimes used. A pain specialist may be involved. (Mayo Clinic; NHS; ACG)
Pancreatic enzyme replacement therapy (PERT). If the pancreas cannot make enough enzymes, capsules taken with meals and snacks help you digest food, especially fat. NIDDK also mentions vitamins A, D, E, and K if absorption is poor, and vitamin B12 injections if needed. (NIDDK; Mayo Clinic; HaPanEU)
Diabetes care. Eating plan, medicines or insulin, glucose monitoring, regular check-ups. (NIDDK; NHS)
Diet. A dietitian can help you meet your nutrient needs. NIDDK often describes a healthy, lower-fat pattern with smaller, more frequent meals during recovery from inflammation. NHS emphasises a healthy, balanced diet so you get the nutrients you need. Follow the advice given to you — it can differ during a flare versus long-term chronic disease. (NIDDK — Eating, diet & nutrition; NHS)
Treating the cause. For example, steroids may help if the immune system is attacking the pancreas. (NHS)
Procedures and surgery. To drain cysts, relieve pressure or blockage in the pancreatic duct, remove damaged tissue, or, rarely, remove the pancreas. In selected patients who do not improve otherwise, total pancreatectomy with islet auto-transplantation is described by NIDDK: islets are taken from the removed pancreas and placed in the liver so they can still make insulin. (NIDDK; Mayo Clinic; ACG)
Related reading: pancreatitis life expectancy and necrotizing pancreatitis.
Things you can do
NHS, NIDDK, Mayo Clinic, ACG, and HaPanEU agree on two points that are not optional extras:
- Do not drink alcohol — even if alcohol did not cause your pancreatitis. Continuing to drink makes severe complications and death more likely when alcohol was the cause.
- Do not smoke — stopping can slow damage. Smoking worsens chronic pancreatitis and is a risk factor for pancreatic cancer.
(NHS; NIDDK; Mayo Clinic; ACG)
You will need regular check-ups for diabetes, nutrition, and bone health. Living with pain, nausea, and a long-term illness is hard; NHS points people to charities such as Guts UK and Pain Concern for support. (NHS)
This site does not sell or recommend enzyme brands, supplements, or “natural” pancreas products. Enzyme replacement is a prescribed medicine.
See also: What is pancreatitis · Acute pancreatitis · Symptoms and causes · Statistics
Last editorial check: 29 August 2026. NHS chronic page last reviewed 20 October 2025.
NHS says chronic pancreatitis can affect how long you live and that most people still live with it for many years — outlook context sits with Pancreatitis life expectancy and Can you die from pancreatitis? For coding, use Chronic pancreatitis ICD-10 (K86.1) and the Pancreatitis ICD-10 hub.