Chronic pancreatitis
Definition
Chronic pancreatitis is swelling (inflammation) of the pancreas that leads to scarring and loss of function. The pancreas is an organ located behind the stomach that produces chemicals needed to digest food. It also produces the hormones insulin and glucagon.
Causes
Chronic pancreatitis causes inflammation and scarring of tissue in the pancreas. This makes the pancreas unable to produce the right amount of chemicals (enzymes) needed to digest fat. It also interferes with insulin production, which may lead to diabetes.
The condition is most often caused by alcoholism and alcohol abuse. Sometimes the cause cannot be determined, however. Genetic causes have become more common. Other conditions have also been linked to chronic pancreatitis, such as:
- Chronic blockage of the pancreatic duct
- Injury
- Hyperlipidemia
- Hyperparathyroidism
Chronic pancreatitis occurs more frequently in men than in women. This may be because alcohol-use disorders are more common in men.
Symptoms
- Abdominal pain
- Greatest in the upper abdomen
- May last from hours to days
- Eventually may be continuous
- May be worsened by eating or drinking
- May be worsened by drinking alcohol
- May spread (radiate) to the back
- Digestive problems
- Fatty stools
- Nausea and vomiting
- Pale or clay-colored stools
- Unintentional weight loss
The symptoms may become more frequent as the condition gets worse. The symptoms may mimic pancreatic cancer. Sitting up and leaning forward may sometimes relieve the abdominal pain of pancreatitis.
Exams and Tests
Tests for pancreatitis include:
Inflammation or calcium deposits of the pancreas may be seen on:
An exploratory laparotomy may be done to confirm the diagnosis of pancreatitis.
Treatment
The goal of treatment is to:
- Prevent indigestion
- Reduce pain
- Reduce stimulation of the pancreas
- Treat diabetes (if present)
Treatment may involve:
- Analgesics or surgical nerve block to relieve pain
- Eating a low-fat diet
- Getting enough vitamins and calcium in the diet
- Taking insulin to control blood sugar levels
- Taking supplemental pancreatic enzymes
Do not drink alcohol.
Surgery may be recommended if a blockage is found. In severe cases, part or all of the pancreas may be removed.
Outlook (Prognosis)
This is a serious disease that may lead to disability and death. You can reduce the risk by avoiding alcohol.
Possible Complications
- Ascites
- Blockage (obstruction) of the small intestine or bile ducts
- Blood clot in the vein of the spleen
- Fluid collections in the pancreas (pancreatic pseudocysts) that may become infected
- Poor function of the pancreas
- Diabetes
- Fat malabsorption
When to Contact a Medical Professional
Call for an appointment with your health care provider if:
- You develop symptoms of pancreatitis
- You have pancreatitis and your symptoms worsen or do not improve with treatment
Prevention
Determining the cause of acute pancreatitis and treating it promptly may help to prevent chronic pancreatitis. Avoiding heavy consumption of alcohol dramatically reduces the risk of developing this condition.
References
Nair RJ, Lawler L, Miller MR. Chronic pancreatitis. Am Fam Physician. 2007;76:1679-1688.
Reviewed By: Christian Stone, MD, Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
