IBD and Pancreatitis

Ulcerative colitis is a type of inflammatory bowel disease (IBD). It causes long-term inflammation and ulcers (sores) on the inner lining of the large intestine. The other common type of IBD is Crohn’s disease. The main organs affected by IBD are in the digestive tract. But about 50 percent of people with IBD also have symptoms that affect other organs. Studies show that pancreas is one such organ that may be affected by IBD.¹

Understanding the different types of pancreatitis that are linked to ulcerative colitis and other types of IBD, along with their causes and symptoms, can help you get the right diagnosis and treatment.

What is pancreatitis?

The pancreas is located close to the large intestines. The pancreas makes enzymes that help your body digest food and regulate blood sugar.²

Pancreatitis occurs when digestive enzymes start working while they are still in the pancreas instead of the intestines. This causes inflammation in the pancreas. Symptoms of pancreatitis include:²

• Pain in the upper part of the abdomen (belly)
• Abdominal pain that radiates to your back
• Tenderness when touching the abdomen
• Fever
• Fast heartbeat
• Nausea and vomiting

Pancreatitis can be caused by different conditions and risk factors. If not treated, pancreatitis can damage the pancreas and cause it to stop working. Over time, this can cause digestion problems and diabetes.²

Types of pancreatitis and their link to UC and Crohn's

Many studies have shown that people with IBD have a higher chance of developing several types of pancreatitis, as well as other pancreatic conditions.^1,3-5

Acute pancreatitis

Acute pancreatitis (AP) is a sudden inflammation of the pancreas. This can cause severe pain in the upper part of the belly.^1,3

AP is the most common pancreas related disease linked to IBD. Depending on the type of IBD, 2 to 4 percent of people with IBD may also get diagnosed with AP. A number of studies show that people with IBD have a higher chance of getting AP than people who do not have IBD.^1,3

IBD has been linked to the formation of gallstones. Having gallstones can also lead to acute pancreatitis. But the higher chances of developing gallstones may depend on the type of IBD. For example, people with Crohn's disease are more likely to develop gallstones than people with ulcerative colitis.^1,3,4

Many drugs used to treat IBD, such as thiopurines, have also shown a link to acute pancreatitis. Plus, smoking while taking drugs for IBD can increase the chances of getting acute pancreatitis.^1,3,4

Chronic pancreatitis

Chronic pancreatitis is inflammation of the pancreas that lasts for a long time. This can damage the pancreas.^1,3,4

There are a few studies that suggest that people with IBD have a higher chance of developing chronic pancreatitis. Other types of pancreatitis can also turn into chronic pancreatitis. For example, multiple episodes of acute pancreatitis can develop into chronic pancreatitis. This is more likely if the factors that are responsible for causing pancreatitis (smoking, drugs, etc.) are not removed.^1,3,4

Autoimmune pancreatitis

Autoimmune pancreatitis is inflammation that happens when the body's own immune system attacks the pancreas. There are 2 kinds of autoimmune pancreatitis, known as type 1 and type 2.^1,3,4

Studies show that type 2 autoimmune pancreatitis is much more common in people with IBD than type 1. Also, people who have ulcerative colitis are more likely to get type 2 autoimmune pancreatitis than people who have Crohn's disease.^1,3,4

Exocrine pancreatic insufficiency

Exocrine pancreatic insufficiency (EPI) is when the pancreas does not produce enough enzymes that are used to break down food.³

EPI is common in people with IBD. One study estimated that 22 percent of people with ulcerative colitis also developed EPI.³

Acute idiopathic pancreatitis

Acute idiopathic pancreatitis (AIP) is a type of acute pancreatitis without any known cause. A 2023 study looked at the relation between AIP and IBD. The researchers found that people who had both Crohn's disease and AIP were more likely to develop complications. This could be a change in medicine or dosage, or having a surgery because of Crohn's disease. This was not the case for people with ulcerative colitis.⁵

Talking to your doctor about IBD and pancreatitis

If you live with ulcerative colitis or Crohn's and have symptoms of pancreatitis, talk to your doctor. Depending on the cause of your pancreatitis, your doctor can offer different treatments.