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.

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

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

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

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