Rising Tide of Acute Pancreatitis in India: Causes, Challenges, and Care
Acute pancreatitis (AP), a sudden inflammation of the pancreas, has become an increasingly common and serious health concern in India. Ranging from mild discomfort to life-threatening illness, AP places a heavy burden on patients and the healthcare system.
/*Sharp Increase in Hospitalizations*/
A five-year study from Kashmir (2015–2019) found that AP cases rose sharply—from 5.6% of gastrointestinal emergencies in 2015 to 10.3% in 2019, averaging 8.5% overall (702 of 8,245 GI emergency cases).
/*Shifting Causes:*/
/*Gallstones Dominant*/
Gallstones are responsible for nearly half of AP cases in some regions, with many of the stones under 5 mm in size, often undetected before the onset of pancreatitis.
/*Alcohol-related AP*/
Accounts for approximately 40–50% of cases in certain populations, especially among males consuming locally brewed spirits.
/*Ascariasis infections*/
A previously significant factor has declined sharply over recent years.
/*Other causes*/
Hypertriglyceridemia (~2%), iatrogenic events like ERCP (2–6%), and blunt abdominal trauma in more severe incidents.
Clinical Features & Severity
Patients typically experience acute epigastric pain radiating to the back, nausea, vomiting, fever, and rapid heartbeat. Diagnosis relies on elevated serum amylase/lipase and imaging via ultrasound or contrast-enhanced CT. Severity is classified into mild, moderately severe, and severe based on organ failure and complications. In some parts of Eastern India, mortality among severe cases has been reported at around 18%.
/*Management Protocols*/
Best-practice Indian clinical guidelines include:
Early fluid resuscitation using Ringer’s lactate, multimodal pain control incorporating paracetamol, metamizole, opioids and epidurals when needed
Early enteral nutrition over parenteral alternatives.
Infected necrosis addressed with delayed drainage, antibiotics, and tailored percutaneous or endoscopic intervention.
Organ support (ventilation, dialysis) in ICU settings; and surgical intervention reserved for cases unresponsive to conservative treatment.
/*Preventive Strategies*/
To reduce burden, public health measures emphasize:
1. Alcohol-moderation campaigns, especially among young men.
2. Gallstone screening and elective cholecystectomy.
3.Public education on early recognition of AP symptoms.
/*Way Forward*/
With gallstones and alcohol use as the primary drivers, India needs a multi-pronged strategy—from prevention and early detection to optimal clinical management to mitigate mortality and morbidity from acute pancreatitis.