Pancreatitis

Deep dive

Pancreatitis: complete reference

Pancreatitis is inflammation of the pancreas — acute (sudden onset) or chronic (long-standing). Acute pancreatitis presents with severe upper abdominal pain that may radiate to the back, often с nausea and vomiting. Causes include gallstones (most common), alcohol, hypertriglyceridemia, medications, and genetic factors. GLP-1 receptor agonists have a documented (uncommon) association с pancreatitis — pooled trial data show ~0.2-0.4% incidence over treatment duration, similar to placebo in many analyses but slightly elevated in some. FDA prescribing labels include pancreatitis warnings for all GLP-1s. Patients with history of pancreatitis (especially recurrent) are typically excluded from GLP-1 therapy due to elevated risk. Symptoms warranting immediate evaluation: severe persistent epigastric pain, nausea/vomiting unresolving с antiemetics, pain radiating to back. Lab workup: elevated lipase (most specific) + amylase. Imaging: abdominal CT or MRI.

In practice

Severe abdominal pain that radiates to the back + persistent vomiting on a GLP-1 = immediate ER evaluation. Pancreatitis is uncommon but serious.

Clinical context

Pancreatitis is a documented uncommon adverse event для all GLP-1s. Prior pancreatitis history is a relative contraindication.