In mice with acute pancreatitis, pre-existing metabolic acidosis increases serum amylase levels, pancreatic edema, necrosis, and leukocyte infiltration compared to mice with normal pH.

When the blood is too acidic before pancreatitis starts, the pancreas becomes more sensitive to damage. The low pH causes digestive enzymes inside pancreatic cells to activate too early, which starts breaking down the tissue. This damage triggers a strong inflammatory response, releasing chemicals that pull in immune cells called neutrophils. These immune cells flood the pancreas, causing more swelling, cell death, and tissue destruction. The acidic environment also makes it harder for the kidneys to remove acid, which keeps the blood acidic and worsens the damage.