What is chronic pancreatitis?
Chronic pancreatitis is an ongoing or repeated inflammation of the pancreas.
The pancreas is an organ located behind the stomach. It produces digestive enzymes and insulin. The digestive enzymes flow into the small intestine to help break down food. Insulin is released into the blood to control the level of sugar (glucose) in the blood.
Pancreatitis can be acute or chronic. Acute pancreatitis occurs as one sudden episode. After acute pancreatitis the pancreas usually returns to its normal condition. Chronic pancreatitis means ongoing or repeated bouts of pancreatitis that damage the pancreas. The damaged pancreas gradually becomes unable to make normal digestive enzymes and insulin. It causes frequent attacks of severe pain and can cause life-threatening complications.
How does it occur?
Chronic pancreatitis may result from:
- drinking too much alcohol (the most common cause)
- gallstones, which block the normal flow of pancreatic secretions into the intestines
- too much fat in the blood (a very high triglyceride level).
In rare cases pancreatitis is inherited.
What are the symptoms?
The main symptoms of chronic pancreatitis are:
- severe pain in the stomach area that extends to the back
The pain is usually a constant, dull pain that gets worse when you eat food or drink alcohol. The pain may lessen when you sit up and lean forward. As the disease gets worse, attacks of pain last longer and happen more often. Attacks may last a few hours or as long as several weeks.
Weight loss is another common symptom.
As the pancreas becomes damaged, it produces fewer digestive enzymes for the intestines. As a result, food is poorly absorbed. Bowel movements become frequent and foul smelling.
If the pancreas is unable to produce the hormone insulin, diabetes may develop, causing these symptoms:
- increased thirst
- increased appetite
- increased urination
- weight loss.
How is it diagnosed?
Your healthcare provider will ask about your medical history, particularly about how much alcohol you drink and whether you have had gallstones. Your provider will ask about your symptoms and examine you.
You may have the following tests:
- blood tests, especially to check your blood sugar, amylase, and lipase levels (amylase and lipase are enzymes made by the pancreas)
- urine tests
- X-rays of your abdomen and chest
- ultrasound exam of the pancreas and gallbladder
- CT scan of the pancreas
- endoscopic retrograde cholangiopancreatography (ERCP).
ERCP is a way of looking at your pancreas through a slim flexible tube called an endoscope. The scope is passed through your mouth and stomach to see the area where your pancreas and intestines are connected.
How is it treated?
The goals of treatment are:
- to control the pain
- to prevent further damage to the pancreas
- to prevent further attacks of pancreatitis.
You will need:
- pain medicine
- a diet of foods that are easy to digest
- lots of fluids
- medicine for nausea and vomiting.
If your pancreatitis is severe, you may not be allowed to eat or drink for a few days. In this case you will stay in the hospital so you can be given fluids through your veins (IV).
You may need insulin to control your blood sugar if the pancreas is not producing enough insulin. If the intestine is not getting enough digestive enzymes from the pancreas, you may also need to take enzyme pills to help you digest food.
In some cases your healthcare provider may recommend surgery to help relieve pain or to help the pancreas work better.
If you have alcoholic pancreatitis, no treatment will prevent pancreatitis or relieve your pain if you continue to drink alcohol.
How long will the effects last?
As with any chronic disease, the effects may last for months or years. Your chances for improvement are good if you follow your provider's treatment plan.
If your pancreatitis is caused by gallbladder disease or high blood fats, treating these problems will make future attacks of pancreatitis less likely. This treatment may need to be postponed until the pancreas has recovered from the most recent attack.
How can I take care of myself?
- Do not drink any alcohol. This is the most important thing you can do
- Follow your diet.
- Take the medicine prescribed by your healthcare provider.
How can I help prevent chronic pancreatitis?
If you drink heavily, get help to stop. Talk to your healthcare provider about referral to an alcohol treatment center or a group like Alcoholics Anonymous.
Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.
HIA File gase4005.htm Release 13/2010