Sudden severe upper-abdominal pain that persists or radiates to the back, especially with repeated vomiting, warrants assessment for pancreatitis and other causes. Gallstones and heavy drinking are major causes, but symptoms alone cannot establish the diagnosis; blood tests and imaging when indicated are used together. Severe cases can cause systemic complications, making delays based on an assumption of indigestion risky. After pancreatitis, avoiding alcohol and addressing the cause help prevent recurrence, while treatment depends on severity and gallstone involvement.