Why Pancreatitis Patients Are Advised Not To Drink Water

Pancreatitis is a condition that requires careful management, especially during acute flare-ups. One of the common medical instructions given to patients during an acute episode is to avoid both eating and drinking water. This may seem counterintuitive, but it plays a crucial role in reducing the strain on the pancreas and preventing further complications.

The pancreas produces enzymes that aid digestion, and in a healthy body, these enzymes are released into the small intestine through the pancreatic duct. However, in cases of pancreatitis, this process is disrupted. When a patient drinks water or consumes food, it stimulates the stomach to produce gastric juices, including acid and gastrin. These substances, in turn, signal the pancreas to produce more pancreatic enzymes.

There are several reasons why this increased enzyme production can be dangerous for pancreatitis patients:

1. Obstruction due to stones: Gallstones or pancreatic stones can block the pancreatic duct or bile duct, preventing the normal flow of pancreatic juices.
2. Post-ERCP swelling: Endoscopic Retrograde Cholangiopancreatography (ERCP) is a procedure used to diagnose and treat duct issues, but it can cause temporary swelling of the papilla, which restricts drainage.
3. Pancreatic duct narrowing: Chronic inflammation or tumors can cause the duct to narrow, blocking the outflow of pancreatic secretions.

When the pancreatic duct is obstructed, drinking water or eating can lead to a buildup of enzymes within the pancreas. These enzymes, which are meant to aid digestion in the intestines, begin to activate inside the pancreas, essentially causing the organ to digest itself. This process worsens inflammation and can lead to severe pain and complications.

To manage this condition effectively, doctors often prescribe medications like somatostatin analogs (e.g., octreotide) to suppress enzyme production and reduce pancreatic activity. In addition, treating the underlying cause—such as removing stones or placing a stent during ERCP—is essential for long-term recovery.

Patients must follow medical advice closely and avoid eating or drinking until their condition stabilizes. In severe cases, intravenous fluids are provided to maintain hydration while keeping the pancreas at rest.