6 Root causes of pancreatitis (that you may be missing)

What triggers pancreatitis?

Pancreatitis—an inflammatory condition of the pancreas—can significantly impact digestion and overall health. While alcohol consumption and gallstones are widely recognized as primary causes, there are several other underlying factors that may contribute to the development of this condition.

In this article, we’ll explore some commonly overlooked root causes of pancreatitis and cover the importance of a comprehensive approach to pancreatic health.

Understanding the pancreas

The pancreas is a small but powerful organ that sits behind your stomach. It has two main jobs: helping control your blood sugar and helping you digest food. It does this by making important digestive enzymes like amylase to break down carbs and lipase to break down fats. When your pancreas is working well, your body can absorb the nutrients it needs from food and keep your digestion running smoothly. But when it’s not running smoothly, whether due to inflammation, blocked ducts, or enzyme imbalances, it can lead to a range of health issues, including pancreatitis.

What is pancreatitis?

Pancreatitis refers to inflammation of the pancreas and can show up in several different forms including acute, chronic, hereditary, autoimmune, and familial. Each type has its own unique causes and patterns, ranging from genetic mutations to immune dysfunction.

This article will focus on acute and chronic pancreatitis, as these are most often linked to environmental and lifestyle factors, meaning there’s often something we can do to prevent or address the root cause.

Acute pancreatitis

Acute pancreatitis is a sudden inflammation of the pancreas that can cause intense upper belly pain (which can radiate to the back), nausea, vomiting, and a fast heartbeat. One of the telltale signs is a spike in certain pancreatic enzymes like amylase and lipase in the blood, often 3 times the upper limit of normal. However, not everyone shows elevated enzyme levels right away. In those cases, doctors may use imaging tests, like a CT scan, to get a clearer picture and confirm the diagnosis.

Chronic pancreatitis 

Chronic pancreatitis is long-term inflammation of the pancreas that causes lasting damage over time. As the pancreas becomes more impaired, it struggles to produce the digestive enzymes and hormones your body needs leading to ongoing belly pain, trouble absorbing nutrients, and even diabetes. It’s more common in men and often starts between the ages of 30 and 40. Early on, the symptoms can look a lot like acute pancreatitis, which can make it tricky to diagnose right away.

Both forms can lead to complications such as pancreatic insufficiency, where the pancreas fails to produce adequate digestive enzymes, leading to malnutrition and weight loss.​

Root causes of pancreatitis 

While alcohol and gallstones are commonly blamed for pancreatitis, they’re not the only culprits. A functional medicine approach looks deeper to identify the true drivers of inflammation and dysfunction. In many cases, underlying issues like chronic infections, genetic mutations, food allergies and sensitivities, and an inflammatory diet can set the stage for pancreatic stress and repeated flare-ups. By identifying and addressing these root causes early, we can better support the pancreas, reduce symptoms, and help prevent long-term complications.

1. Genetic mutations and pancreatitis

Pancreatitis doesn’t always come from lifestyle factors, like diet or alcohol use, but instead can come from a genetic factor. Certain inherited gene mutations can make someone more likely to develop pancreatitis, even without common triggers.

Two of the most studied genes linked to pancreatitis are CFTR and SPINK1:

• CFTR is the same gene that causes cystic fibrosis. Mutations in this gene can affect how the pancreas secretes fluids, making it more prone to blockages, inflammation, and enzyme buildup.
• SPINK1 helps control the activity of digestive enzymes. If this gene doesn’t work properly, enzymes may activate too early causing the pancreas to essentially begin digesting itself, which leads to inflammation and damage.
  

People with these mutations may experience recurrent pancreatitis starting in childhood or early adulthood, often without obvious external causes. Over time, repeated inflammation can turn into chronic pancreatitis, leading to digestion problems and even diabetes.

Genetic testing can help identify these mutations, especially in people with unexplained or early-onset pancreatitis. Understanding your genetic risk can also help guide treatment and prevention strategies.

2. Food sensitivities and pancreatitis

Food sensitivities can disrupt gut function and cause systemic inflammation, which may play a role in triggering or worsening pancreatitis in some individuals.

Celiac disease is one of the clearest examples of this connection. In people with celiac disease, eating gluten can sometimes trigger pancreatitis. This happens because gluten can cause inflammation in the small intestine and disrupt hormone signals that help the pancreas work properly.

Function members can add on celiac testing anytime. View the full test list.

3. How diet can trigger pancreatitis

What you eat can have a big impact on the health of your pancreas. Diets that are high in red meat, unhealthy fats, and processed foods, and low in fiber and vegetables, may increase the risk of developing acute pancreatitis, especially when gallstones are involved.

People who eat a lot of saturated fat and cholesterol mainly from foods like red meat have a higher chance of developing pancreatitis. On the other hand, those who eat more fiber-rich foods, like fruits, vegetables, and whole grains, seem to have a lower risk.

Experts believe this is because fatty, meat-heavy meals put extra stress on the pancreas, causing it to release more digestive enzymes. This extra work can trigger inflammation. Diets high in fat may also increase oxidative stress, a kind of internal damage caused by unstable molecules, especially if antioxidant intake (from foods like leafy greens and berries) is low. Over time, this stress can make the pancreas more vulnerable to injury.

For more information, visit Nutrition 101.

4. Chronic viral infections and pancreatitis

Chronic viral infections, particularly hepatitis B (HBV) and C (HCV), are linked to pancreatitis through mechanisms like chronic inflammation and viral DNA integration in pancreatic tissue, increasing the risk of chronic pancreatitis and pancreatic cancer. Epstein-Barr virus (EBV) and cytomegalovirus (CMV) are more commonly associated with acute pancreatitis, especially in immunocompromised individuals

5. Gut dysbiosis and pancreatitis

Your gut and pancreas are more connected than you might think. When the balance of bacteria in your gut gets disrupted, a condition called dysbiosis, it can cause inflammation not just in your gut lining, but also in your pancreas. This often involves increased gut permeability, which allows bacterial byproducts to enter the bloodstream and trigger immune responses in other parts of the body.

See Gut Health 101 for more information.

6. Environmental toxin exposure and pancreatitis

Environmental toxin exposures can increase the risk of pancreatitis by straining the pancreas and making it more vulnerable to injury and inflammation. Common toxins include heavy metals like mercury and arsenic, which can interfere with normal cell function, and pesticides (e.g., organophosphates), which may cause oxidative stress and immune system disruption. Reducing contact with these toxins can help protect pancreatic health and lower the risk of inflammation.

For more information, visit Environmental Health 101.

7. Autoimmune-mediated pancreatitis

Autoimmune activation can contribute to pancreatitis when the immune system, which is supposed to protect the body, mistakenly attacks the pancreas. This attack causes inflammation, swelling, and damage to the pancreas tissues. Over time, the inflammation can interfere with the pancreas’s ability to release digestive enzymes properly, leading to digestive problems and pain. In some cases, the immune system creates specific antibodies that target parts of the pancreas, making the inflammation more severe. This autoimmune process can either trigger sudden (acute) pancreatitis or lead to longer-term pancreatic issues if left unchecked.

Autoimmune pancreatitis (AIP), a form of chronic pancreatitis, is often found in conjunction with other autoimmune conditions like systemic lupus erythematosus, due to shared immune mechanisms, where systemic inflammation driven by overlapping genetic factors and immune dysregulation exacerbates cross-reactive autoimmune responses.

Tests to monitor pancreatic health 

Maintaining pancreatic health is crucial for overall digestion and metabolic functions. Regular monitoring through specific laboratory tests can aid in early detection and management of potential pancreatic issues. Below is an overview of various tests related to pancreatic health, their purposes, and supporting peer-reviewed evidence:​

Lipase and amylase

These two enzymes are commonly measured together in a blood test to evaluate pancreatic health. Elevated levels can signal inflammation or injury to the pancreas, such as in cases of acute pancreatitis.

Amylase levels may rise when the pancreas is inflamed, but they can also increase due to other issues like salivary gland infections (such as mumps).

Lipase on the other hand, is more specific to the pancreas and stays elevated longer during a pancreatitis episode. It’s particularly useful for identifying acute pancreatitis. Because of its specificity, lipase can also help tell the difference between pancreatic and non-pancreatic sources of abdominal pain.

Micronutrient testing

People with pancreatitis often struggle to absorb key nutrients, leading to deficiencies in vitamins A, D, E, B12, C, folic acid, and minerals like zinc and magnesium. However, blindly supplementing isn’t ideal. Testing nutrient levels through bloodwork allows for personalized treatment, helping identify and correct deficiencies early to support pancreatic function and long-term health.

hs-CRP & homocysteine: Markers of systemic inflammation

High-sensitivity C-reactive protein (hs-CRP) and homocysteine are blood markers that indicate systemic inflammation and oxidative stress in the body. Elevated levels of these markers may not directly diagnose pancreatitis, but they can signal underlying inflammation that could be contributing to pancreatic dysfunction. By identifying elevated hs-CRP or homocysteine, practitioners can explore potential root causes such as poor diet, infections, or metabolic issues and tailor a treatment plan to reduce inflammation and support pancreatic healing.

Fasting Glucose, insulin, and hemoglobin A1c (HbA1c): Catch early blood sugar dysregulation linked to pancreatitis

The pancreas plays a key role in blood sugar regulation by producing insulin. When the pancreas is under stress or inflamed as in cases of pancreatitis its ability to manage blood sugar can be affected. Testing HbA1c, fasting glucose, and insulin levels helps catch early signs of blood sugar dysregulation, even before symptoms appear. Early detection allows for targeted dietary and lifestyle changes to protect both metabolic and pancreatic health over time.

Food sensitivity testing

Testing for food sensitivities can be incredibly helpful in identifying hidden triggers of inflammation that may be stressing the pancreas. When your immune system reacts to certain foods, even without obvious symptoms, it can lead to chronic, low-grade inflammation throughout the body. Over time, this systemic inflammation can impact pancreatic function and may contribute to the development or worsening of pancreatitis in susceptible individuals. By pinpointing specific food sensitivities through testing, you can eliminate those triggers from your diet, reduce the inflammatory load on your body, and give your pancreas a better chance to heal and function properly. It’s a proactive way to support both digestive and pancreatic health by removing a key source of immune activation.

Chronic viral infection testing

Chronic viral infections can impact the pancreas by causing long-term inflammation. This ongoing immune response may raise the risk of chronic pancreatitis. Function offers add-on tests for:

• Epstein-Barr Virus (EBV):
  
  • VCA IgM
  • VCA IgG
  • Early Antigen D IgG
• Hepatitis B:
  
  • Surface antibody
  • Core antibody 
  • Surface antigen
• Hepatitis C
• Cytomegalovirus (CMV):
  
  • IgM
  • IgG

Galleri multi-cancer early detection test by GRAIL

Pancreatitis increases the risk of developing pancreatic cancer. And routine cancer screenings only catch 14% of cancers. That’s where the Galleri test comes in. The Galleri® multi-cancer early detection test by GRAIL screens for 50+ types of cancer through a single blood draw—often before symptoms appear. It looks for abnormal DNA patterns shed by tumors and gives you the chance to catch cancer signals up to 4 years before traditional screening methods. Access the Galleri test through Function. 

How to eat for pancreatic health

Individuals with acute or chronic pancreatitis are often placed on a strict diet to reduce inflammation and support healing. To help prevent pancreatitis or support overall pancreatic health, it's important to follow a nutrient-dense, whole foods diet that focuses on reducing inflammation, supporting digestion, and maintaining stable blood sugar levels.

To protect the pancreas, it’s best to avoid:

• Excess alcohol
• High-fat, high-sugar meals
• Ultra-processed and fried foods

To protect the pancreas, it’s best to eat:

• Anti-inflammatory foods, particularly rich in omega-3 fatty acids
• Fiber
• Gut-friendly foods

Adopting a pancreas-friendly anti-inflammatory diet not only helps reduce the risk of inflammation and flare-ups, but also promotes steady energy levels, improved digestion, and better overall metabolic health.

Takeaway

Pancreatitis doesn’t have to be a mystery or something you only address when symptoms strike. By taking a proactive, root-cause approach that looks at gut health, nutrient status, and key lab markers, you can support your pancreas now and in the future. Testing, individualized protocols, and working with a healthcare provider can make all the difference in preventing flare-ups, reducing inflammation, and protecting long-term digestive and metabolic health.