Alcohol-Induced Pancreatitis

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Alcohol use is one of the most common causes of acute pancreatitis, responsible for about 17% to 25% of cases.¹ Acute pancreatitis is characterized by inflammation of the pancreas, whereas chronic often results from several occurrences of acute pancreatitis. Alcohol pancreatitis is a serious medical condition that requires immediate medical attention.

The Role of the Pancreas

The pancreas, an organ located near the liver, gallbladder, and stomach, is responsible for producing hormones like glucagon and insulin, which regulate your blood sugar. The pancreas also produces digestive enzymes, which help with the digestive process.^1,2

Pancreatitis

Pancreatitis is a necro-inflammatory disease, meaning the pancreas is infiltrated by inflammatory cells, and the destruction of pancreatic cells occurs. Pancreatitis is a serious gastrointestinal illness and important health concern that affects approximately 17 million people around the world.^1,2 In the United States, pancreatitis hospitalization accounts for a range of from 13 to 45 cases per every 100,000 people. Acute pancreatitis is the most frequent cause of hospital admissions.²

Pancreatitis can be identified in two stages: acute and chronic.^1,3 Acute pancreatitis is a sudden inflammation of the pancreas. Acute pancreatitis typically lasts for a short amount of time, and the pancreas returns to its normal state.4 Short-term heavy alcohol use can result in acute pancreatitis.

Chronic pancreatitis typically begins with recurrent episodes of acute pancreatitis attacks and is used to describe chronic inflammation of the pancreas.³ Long-term alcohol use can result in the development of chronic pancreatitis.If your pancreatitis is severe enough, regardless of acute or chronic, it can cause multiple organ failure and death.¹

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What is Alcohol-Induced Pancreatitis?

Alcohol-induced pancreatitis is pancreatitis that has a main contributing factor of excessive and/or chronic alcohol use. Current research shows alcohol misuse is a very common factor in the development of pancreatitis.^1,5

Alcohol-induced pancreatitis can cause chronic pancreatitis, which can be life-threatening.¹ Research indicates that alcohol seems to be the main factor in approximately 44% of the cases in the United States.⁵

Furthermore, the use of alcohol increases susceptibility to developing acute and chronic pancreatitis, although it does not cause it on its own. Alcohol withdrawal has also been shown to increase the risk of developing pancreatitis.³

Pancreatitis is five times more likely to present in men than women.⁵ For men, their acute pancreatitis attack is more often related to their alcohol use, whereas, with women, it is more likely to be related to a biliary tract disease.⁶

Pancreatitis is also more common in Black people, and upwards of three times more Black people are hospitalized than are white people.^5,6 Research studying the disparity has posited that risk factors for Black men may include a higher rate of alcohol misuse, diabetes, and family history of pancreatic cancer.^7,8 Studies have also suggested race may be a general risk factor for developing pancreatitis.⁷

How Does Alcohol Cause Pancreatitis?

The use of alcohol alone is unable to cause pancreatitis. It is believed that alcohol and its metabolites predispose the pancreas to damage, whereby the damage is caused by various agents that on their own would not cause such damage.¹

Additionally, some factors that are believed to trigger alcoholic pancreatitis include:¹

• Cigarette smoking
• Infectious diseases
• High-fat diet
• Genetic predispositions

As the alcohol sensitizes the pancreas to these external factors, they interact with each other, and the level of ethanol (i.e., alcohol) toxicity increases.⁵ Research indicates approximately less than 10% of heavy drinkers will develop chronic pancreatitis.⁵ In developing countries, approximately 35% of acute pancreatitis cases and 70% of chronic pancreatitis cases are associated with alcohol misuse, typically caused by long-term alcohol use.¹

Moreover, although alcohol-induced pancreatitis can remain in the acute stage of the disease, for many, their acute pancreatitis can progress into chronic alcohol-induced pancreatitis.¹

Alcoholic Pancreatitis Symptoms

Symptoms of alcoholic pancreatitis include:^3,4

• Abdominal pain
• Digestive problems
• Weight loss
• Nausea
• Vomiting
• Fever
• Swelling and feeling sore
• Fluid buildup in the abdomen
• Low blood pressure
• Jaundice (i.e., the yellowing of skin and eyes)

Pain is typically the first sign of this condition, and it is also the most disabling and prominent symptom. More specifically, the pain originates in the upper stomach area and radiates to the back. Although this is the most common symptom, some people do not experience pain.³

Complications of pancreatitis may include:⁴

• Chronic pain
• Diabetes
• Weight loss
• Diarrhea
• Blockages of the bile duct
• Low levels of vitamin malabsorption
• Pancreatic cancer

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How Long Does Alcohol-Induced Pancreatitis Last?

The length of time that symptoms of alcoholic pancreatitis will last depends on the severity of such symptoms. Typically, acute pancreatitis symptoms get better within a few days, but continued acute pancreatitis can result in chronic pancreatitis.⁴ Research indicates that between the onset of acute symptoms and the diagnosis of chronic pancreatitis is approximately 30-55 months in those with alcohol use disorder. For individuals without alcohol use disorder, the progression is approximately 81 months.³

As you stop the use of alcohol, the risk of developing pancreatitis does decrease, though it can be difficult to reduce or discontinue alcohol use if you are struggling with alcohol use disorder.⁵ The continued use of alcohol despite negative consequences is one of the hallmark features of alcohol use disorder, or alcohol addiction.

If you feel you are unable to control your use, it is recommended you work with your provider and seek treatment to assist you with abstaining from alcohol use. You can call us at 800-948-8417 Calls are forwarded to these paid advertisers to discuss treatment options.

Can Alcoholic Pancreatitis be Cured?

Each year approximately 220,000 people are admitted to the hospital for acute pancreatitis. Of those, 20% of people have severe complications. The mortality rate of pancreatitis is around 10 to 30% of these severely complicated cases.¹

A lot is still unknown about chronic pancreatitis; however, research indicates once the disease process begins, it probably cannot be reversed.³ Notably, there have been some cases in which the pancreas regenerated cells to replace the diseased and deceased cells.¹

Fortunately, symptoms and the rate of progression can be modified by interventions. However, inflammation that occurs from chronic and prolonged pancreatitis can result in irreversible scarring.^2,3

Pancreatitis can be rapidly progressing and with a lack of early diagnostic testing, the development of pancreatic cancer is possible.²

How Much Alcohol Do You Have to Drink to Get Pancreatitis?

Although seen in lesser amounts and fewer years, research estimates that approximately 80 grams of alcohol per day for more than 6-12 years is required to produce symptomatic pancreatitis.⁵ For reference, 80 grams of alcohol equates to about ½ pint of hard liquor, eight standard-sized beers, or about a liter of wine.⁹

How Is Alcohol Pancreatitis Diagnosed?

When diagnosing pancreatitis your doctor will obtain a personal and familial history including your alcohol and drug use history. The provider will also complete a physical exam. During this physical exam, you will likely have blood and imaging tests conducted.⁴

These tests include:⁴

• Abdominal x-ray
• CT scans
• Magnetic resonance cholangiopancreatography
• Ultrasounds
• Endoscopic ultrasound
• Endoscopic cholangiopancreatography

An abdominal x-ray shows images of bones, organs, and tissues. CT scans are similar to x-rays but are more detailed. In a magnetic resonance cholangiopancreatography, dye is inserted through your vein, and the magnetic resonance imaging (MRI) shows detailed images of your pancreas, gallbladder, and bile and pancreatic ducts. An endoscopic ultrasound and endoscopic cholangiopancreatography utilize an endoscope (i.e., a thin, flexible tube with a camera on the end of it) to assist with these. Ultrasounds utilize sound waves to view and examine blood flow, and a cholangiopancreatography includes the use of a dye that will then be seen on an x-ray.⁴

Alcoholic Pancreatitis Treatment

At present, no pharmacotherapies are available for acute pancreatitis.¹ In the past, treatment for severe pancreatitis included surgical treatment, even those these past surgical treatments had mortality rates of often over 50%.² Although no specific treatments have been established, providers will treat the symptoms (e.g., pain).

Since alcohol is the main contributor to alcohol-induced pancreatitis, it is important to cease all alcohol use. If not, the use of alcohol will continue to cause inflammation and damage in your pancreas. This also increases your risk of developing chronic pancreatitis.

When seeking treatment at a hospital for pancreatitis, you will likely be admitted for a few days and given intravenous fluids. If needed, you will also likely be prescribed pain medication and antibiotics. Additionally, a low-fat diet will be encouraged.⁴

If you are experiencing these symptoms, please see your primary care physician or go to your nearest hospital.

If you are unable to control or cut back on your alcohol use, this could be a sign of an alcohol use disorder. Please give us a call at 800-948-8417 Calls are forwarded to these paid advertisers to speak with a treatment support specialist.

Resources

1. Clemens, D., Schneider, K. J., Arkfeld, C. K., Grode, J. R., Wells, M. A., & Singh, S. (2016). Alcoholic pancreatitis: New insights into the pathogenesis and treatment. World Journal of Gastrointestinal Pathophysiology, 7(1), 48-58
2. Adejumo, A., Akanbi, O., Adejumo, K., & Bukong, T. (2018). Reduced risk of alcohol-induced pancreatitis with cannabis use. Alcoholism: Clinical and Experimental Research, 43(2), 277-286.
3. Brock, C., Nielsen, L. M., Lelic, D., & Drewes, A. M. (2013). Pathophysiology of chronic pancreatitis. World Journal of Gastroenterology, 19(42), 7231-7240.
4. John Hopkins Medicine. (2022). What is pancreatitis?
5. Kleeff, J., Whitcomb, D. C., Shimosegawa, T., Esposito, I., Lerch, M. M., & Gress, T., Mayerle, J., Drewes, A. M., Reours, V., Akisik., F., Dominguez Munoz, J. E., & Neoptolemos, J. P. (2017). Chronic pancreatitis. Nature Reviews Disease Primers, 3(1).
6. Tang, J. C. F., & Markus, J. T. (2021). Acute pancreatitis.
7. GI Associates & Endoscopy Center. (2016). African Americans and pancreatitis.
8. Silverman, D. T., Hoover, R. N., Brown, L. M., Swanson, G. M., Schiffman, M., Greenberg, R. S., Hayes, R. B., Lillemoe, K. D., Schoenberg, J. B., Schwartz, A. G., Liff, J., Pottern, L. M., & Fraumeni, J. F., Jr (2003). Why do Black Americans have a higher risk of pancreatic cancer than White Americans?. Epidemiology (Cambridge, Mass.), 14(1), 45–54.
9. Richmond County Medical Society. (2019). Alcoholic liver disease develops in stages over years.