Chronic Pancreatitis


Chronic Pancreatitis

Pancreatitis inflames the pancreas, causing digestive enzymes to attack the tissue that produces them. Pancreatitis is considered chronic when the pancreas becomes scarred.

unhealthy pancreatitis

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Learn More: Acute Pancreatitis

Causes

While the cause cannot always be determined, chronic pancreatitis is often caused by years of alcohol abuse. Repeat episodes of acute pancreatitis can lead to a chronic condition. Genetics may also be a factor in some cases.

Risk Factors

Chronic pancreatitis is more common in men than women, often developing in people ages 30 to 40.

Chronic pancreatitis has also been linked to these conditions:

  • Autoimmune problems
  • Blocked pancreatic duct
  • Complications of cystic fibrosis
  • High levels of fat, called triglycerides, in the blood
  • Hyperthyroidism
  • Use of certain medications (especially estrogens, corticosteroids, thiazide diuretics and azathioprine)

Symptoms

  • Abdominal pain (greatest in the upper abdomen and sometimes felt in the back) that may last from hours to days
  • Pain that gets worse from eating or drinking (especially alcohol)
  • Chronic, unintentional weight loss
  • Diarrhea or irregular stools, nausea and vomiting

Diagnostic Tests

  • Endoscopic ultrasound (EUS)
  • Blood tests
  • Ultrasound 
  • Computerized tomography (CT) scan 
  • Magnetic resonance imaging (MRI)
  • Stool tests

When to See a Doctor

If you notice symptoms of pancreatitis, it's important to see a doctor. Always seek medical advice if you have persistent abdominal pain.

For those with a history of pancreatitis, consult a doctor if your symptoms worsen or don't get better with treatment.

If you have chronic pancreatitis, you usually won't need to go to the hospital unless your pain is severe or there are complications. Your doctor may suggest pain-relieving medications. To avoid more pain, stick to low-fat meals and stay away from alcohol. 

At Charleston GI, our board certified gastroenterologists can diagnose and treat your chronic pancreatitis. No referral needed! 

Treatment

It is recommended that all patients make the following lifestyle changes:

  • Drink plenty of fluids
  • Eat a low-fat diet
  • Consult a nutritionist to ensure a diet rich in the proper vitamins and minerals
  • Eat small, frequent meals
  • Limit caffeine
  • Avoid smoking and alcohol

For those with severe pain or serious weight loss, a hospital stay may be necessary, accompanied by the following:

  • Pain medicines
  • Fluids given through a vein (IV)
  • Stopping food or fluid by mouth to limit the activity of the pancreas, and then slowly starting an oral diet
  • Inserting a tube through the nose or mouth to remove the contents of the stomach (nasogastric suctioning) may sometimes be done. The tube may stay in for 1 – 2 days, or sometimes for 1 – 2 weeks.

Other treatments may involve:

  • Pancreatic enzymes to help digest food and gain weight
  • Pain medication or a surgical nerve block to relieve pain
  • Insulin to control blood sugar levels

Prevention

Here are some lifestyle changes that can be beneficial if you're dealing with pancreatitis:

  • Drink more water.
    • Stay hydrated by drinking more fluids throughout the day. Keep a water bottle or glass of water handy.
  • Quit smoking.
  • Quit drinking alcohol.
  • Opt for a low-fat diet.
    • Choose meals that limit fat and focus on fresh fruits and vegetables, whole grains, and lean protein.
  • Consider dietary adjustments.
    • Such as eating small, frequent, low-fat meals, which can reduce pain and complications.

For pain relief, here are some alternative options. To be clear, these options will not cure pancreatitis, however, some may help you manage the pain. 

Pain relief for chronic pancreatitis include:

  • Acupuncture
  • Meditation
  • Relaxation exercises
  • Yoga

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Chronic Pancreatitis Frequently Asked Questions

 

How long can you live with chronic pancreatitis?
Chronic pancreatitis is a serious condition that can, in severe cases, be fatal. Complications from chronic pancreatitis, such as pancreatic cancer or diabetes, may reduce life expectancy. Surgical complications can also cause serious health issues, and in the worst cases, death. Studies show that up to 80% of those diagnosed with chronic pancreatitis will live at least another ten years.

What is chronic pancreatitis?
Chronic pancreatitis is a gastrointestinal condition that refers to the inflammation of your pancreas. The pancreas sits behind the stomach and produces enzymes used to aid digestion. It also secretes hormones that regulate blood sugar levels. Bouts of inflammation that occur suddenly and do not last long are characteristic of acute pancreatitis.  If the condition does not improve over time, it is then considered chronic.  

How is chronic pancreatitis diagnosed? 
At Charleston GI, our gastroenterologists utilize the following diagnostic tests:

  • Fecal fat test
  • Serum amylase
  • Serum IgG4 (for diagnosing autoimmune pancreatitis)
  • Serum lipase
  • Serum trypsinogen

Can chronic pancreatitis be cured? 
While there is no cure for chronic pancreatitis, medication can be used to manage pain. Keep in mind that, because this gastrointestinal condition is linked to alcohol consumption, it is best to abstain. Surgery may also be an option.

Is chronic pancreatitis fatal? 
In some cases, yes. Some chronic pancreatitis sufferers die from surgical complications or pancreatic cancer that result from their condition.

What happens if you keep drinking alcohol after being diagnosed with chronic pancreatitis?
If you have been diagnosed with chronic pancreatitis, your GI specialist will strongly discourage you from drinking alcohol. Not taking their advice could damage your pancreas further, cause pain, and even decreases your lifespan. It also boosts the chances of developing dangerous complications, such as diabetes.

Does chronic pancreatitis cause diarrhea? 
Yes, diarrhea is a symptom of chronic pancreatitis. Other symptoms include upper abdominal pain and vomiting. 

What is the difference between acute pancreatitis and chronic pancreatitis?
Both conditions refer to pancreatic inflammation, but differ on the length of time that symptoms last. Acute pancreatitis refers to an isolated episode, often linked to alcohol abuse or biliary stones. Pancreatitis is considered chronic when symptoms do not improve over time. 

What is the life expectancy of someone with chronic pancreatitis?
Up to 80% of chronic pancreatitis patients will live at least ten years past their diagnosis.

Can chronic pancreatitis turn into pancreatitis cancer? 
Chronic pancreatitis can increase your chance of developing pancreatic cancer. Research reveals that, five years post-diagnosis, chronic pancreatitis patients’ risk increases eight-fold. 

Who is at risk for chronic pancreatitis?
Alcohol abuse is a risk factor, increasing heavy drinkers’ odds of developing chronic pancreatitis. Family history can also play a role. Chronic pancreatitis most commonly occurs in people between the ages of 30 and 40, affecting men more often than women.

Does pancreatitis affect bowel movements?

Yes, a lack of digestive acid can impact the GI system, making it difficult to break down fats and certain proteins. This often causes stool to be more smelly or greasy than usual.

Does pancreatitis cause gas?

Exocrine pancreatic insufficiency (EPI), the result of multiple bouts of acute or chronic pancreatitis, can cause gas and bloating. Other symptoms include chronic diarrhea, unintentional weight loss, and malnutrition.

Is coffee bad for pancreatitis?

Because coffee can cause dehydration, it is often considered a “no-no” for pancreatitis patients. However, research has shown that it may actually help prevent pancreatitis in some cases, earning coffee a spot on some gastroenterologists’ “recommended” lists.

Can you drink any alcohol with pancreatitis?

If you have chronic pancreatitis, our Charleston GI doctors recommend not drinking alcohol. Keep in mind that this also includes any “alcohol-free” beverages, since many still contain up to 0.5% alcohol by volume. Alcohol, even a very small amount, can worsen pancreatitis and lead to further damage.

Do all heavy drinkers get pancreatitis?

Approximately 45% of chronic pancreatitis-related fatalities are linked to alcohol abuse. But only 10% of those who abuse alcohol develop inflammation of the pancreas. The reason behind this remains unknown, but researchers suspect that certain people are simply more susceptible than others.

Can I eat scrambled eggs with pancreatitis?

Since egg yolks are high in fat, they are harder for those with pancreatitis to digest. Instead, choose egg whites that are naturally lower in fat, but still offer great protein. 

On which side of the pancreas do women feel pain?

Both men and women typically experience pancreatitis pain in the upper left side or middle of the abdomen. Pain may worsen within minutes of eating or drinking, and more commonly when consuming high-fat foods. Pain may become constant and more severe, sometimes persisting for several days.

Your pancreas lies along the first segment of your small intestine, called the duodenum. The right side of your body contains the head of your pancreas, while the tail of your pancreas can be found on the left side.

Where is the pain of pancreatitis felt?

Pancreatitis pain is typically felt in the upper left side of the abdomen, just below the ribs. It can also be felt in the middle of the abdomen. You may experience pain that does the following:

  • Radiates to your back or below the left shoulder blade
  • Worsens after eating, especially fatty foods
  • Becomes more severe when lying flat on the back
  • Gets more severe and constant with time

What causes pancreatitis?

When functioning properly, the pancreas secretes enzymes that are activated when they reach the stomach. When the enzymes get activated in the pancreas instead, painful inflammation results, causing a condition called acute pancreatitis. If these enzymes continue to get activated, scarring of the pancreas may occur over time. This results in chronic pancreatitis, a condition that causes frequent abdominal pain. Eventually, the scar tissue causes the pancreas to lose function and impedes digestion.

Pancreatitis may be caused by the following:

  • Abdominal surgery
  • Alcoholism
  • Gallstones
  • Hypertriglyceridemia (high triglyceride levels in the blood)
  • Infection
  • Trauma to the abdomen
  • Obesity
  • Some medications
  • Hyperparathyroidism (an overactive parathyroid gland)
  • Cancer of the pancreas
  • Cystic fibrosis
  • Endoscopic retrograde cholangiopancreatography (ERCP) (a surgical procedure used to treat gallstones)

In some cases, the cause of pancreatitis is unknown.

Certain risk factors may increase your risk of pancreatitis, like these:

  • Excessive alcohol consumption
  • Cigarette smoking
  • Family history of pancreatitis
  • Obesity

How is pancreatitis treated?

Acute pancreatitis or an acute attack of chronic pancreatitis is treated in the hospital in the following ways:

  • Fasting: Your gastroenterologist may ask you to avoid eating anything for a few days to allow your pancreas to recover. Later, liquids and bland food will be reintroduced.
  • Intravenous (IV) fluids: These fluids help keep you hydrated and ensure proper nutrition.
  • Painkillers: Strong medications may be prescribed to manage abdominal pain.

After your condition has stabilized, your GI doctor may recommend surgery, depending on the cause of your pancreatitis. These surgeries may help alleviate pain and prevent further damage:

  • Surgery to remove obstructions in the bile duct (such as a calculus or stone)
  • Cholecystectomy (surgery to remove the gallbladder)
  • Surgery to remove the damaged tissue from the pancreas
  • Surgery to block the nerves that cause pain

Other treatments include the following:

  • Lifestyle modification (change in diet, quitting drinking, etc.)
  • Pancreatic enzyme supplements

When does pancreatitis become fatal?

If it becomes very severe, complications of acute pancreatitis can be deadly. In a small percentage of patients, severe acute pancreatitis causes a systemic reaction that leads to shock and multiple organ failure. This can be fatal if not treated immediately.

Can the pancreas heal itself?

Chronic pancreatitis destroys pancreas function, and therefore, requires medical treatment.

While this condition cannot heal itself, proper medical management can slow down its progression. In addition to improving a patient’s overall quality of life, treatment also helps prevent further issues.

Can pancreatitis be cured?

While there is no known cure for chronic pancreatitis, pain and symptoms may be managed – or in some cases, prevented. Since chronic pancreatitis is most often caused by drinking, abstinence from alcohol is often a good place to start in finding relief.

Can you live without pancreas?

It is possible to live a healthy life without a pancreas, but it requires ongoing medical care.

Pancreas removal causes diabetes because it alters the body's ability to digest food – which then requires lifelong diabetes treatment. This includes eating a low-sugar, low-carbohydrate diabetes diet and getting regular insulin injections. In some cases, injections are replaced by an insulin pump. Patients may need to take digestive enzymes with each meal to ensure proper nutrient absorption.

Your Charleston GI doctor may recommend eating several smaller meals throughout the day to avoid blood sugar spikes. Avoiding drugs and alcohol can also help maintain long-term health.

What are the first signs of a bad pancreas?

Initial symptoms may include the following:

  • Severe belly pain spreads to the back or chest (and may feel worse after eating)
  • Nausea
  • Vomiting
  • Rapid heart rate
  • Fever
  • Swelling and feeling sore/tender in the upper belly
  • Fluid buildup in the belly
  • Lowered blood pressure

What is a pancreas transplant for?

A pancreas transplant replaces a person’s pancreas that can no longer produce insulin with a healthy one from a donor who has died. The first pancreas transplant was performed in 1966. However, it was not until the 1990s that this kind of transplant became a common practice among GI doctors.

In type 1 diabetics, the pancreas is unable to produce insulin. A transplant allows people with type 1 diabetes to maintain their blood sugar levels without receiving extra insulin or intensive monitoring.

There are three types of pancreas transplants:

  • Pancreas transplant alone: This is performed on type 1 diabetics with no kidney problems.
  • Simultaneous kidney and pancreas transplant: This is performed on patients with type 1 diabetes as well as end-stage renal disease.
  • Pancreas after kidney transplant: This is when a kidney transplant is performed first, from a living donor. The pancreas transplant from a deceased donor occurs later when an organ becomes available.

Who needs a pancreas transplant?

A pancreas transplant is an option for people with type 1 diabetes who cannot control their condition with insulin or oral diabetic medicine. The surgery is only appropriate for people with type 1 diabetes.

People with type 1 diabetes who might benefit from a pancreas transplant include those who:

  • Regularly pass out
  • Require routine visits to the emergency room due to blood sugar levels
  • Have uncontrolled average blood sugar levels
  • Need a caregiver to be present in case of emergencies, despite recommended medical therapies

What can be mistaken for pancreatic cancer?

Pancreatic cancer can be difficult to diagnose, with symptoms that are often vague – and mistaken for other more common conditions.

Studies have found that pancreatic cancer is sometimes misdiagnosed as conditions including:

Misdiagnosis of pancreatic cancer can increase the time between initially visiting the doctor and getting the correct diagnosis. Patients who are misdiagnosed also have, on average, more visits to their physician and more diagnostic tests. Keep in mind that the later the diagnosis, the higher the risk.

To help your Charleston GI doctor correctly diagnose your condition as quickly as possible, record your symptoms carefully and share them with your gastroenterologist.

 


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