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Chronic Pancreatitis

Q: Two weeks ago I began experiencing nausea, fever and severe pain in my upper abdomen, plus I was so bloated that I looked five months pregnant. I finally went to the hospital where I was diagnosed with chronic pancreatitis. The doctor recommended an OTC painkiller, but it does nothing to ease the bloat. Is there anything else I can do to feel better?

Dr. Donnica:
Chronic pancreatitis is an on-going inflammatory condition that causes permanent damage to the pancreas, an essential organ behind the stomach. The pancreas produces and secretes the critically important hormones insulin, glucagon, and somatostatin, which aid in digestion and regulate blood sugar. When the pancreas is damaged, problems with digestion, absorption, and diabetes may result.

People with chronic pancreatitis often experience severe pain, nausea, weight loss, diarrhea, and diabetes or vitamin deficiencies. It usually takes several years for permanent changes and symptoms to occur. Most cases are caused by alcohol abuse, but other causes include heredity; gallstone or other blockages of the duct draining the pancreas; tumors; or cystic fibrosis.

Your doctor must thoroughly evaluate you for all of these conditions. Treating the conditions themselves may help improve your symptoms significantly. I am particularly concerned about your complaint of "bloating." Before recommending how to treat it, your doctor must make sure this is truly bloating (distention of the bowel from gas) and not ascites or fluid in the abdomen. This is another common cause of abdominal distention with pancreatic disorders and it would be treated very differently than bloating. I recommend that you discuss this with your physician as soon as possible. In the meantime, avoid alcohol completely, avoid fatty foods, and try a low carbohydrate diet. An over-the-counter medicine such as Gas-X™ may help if your symptoms are due to bloating, but dietary management may help even more.

Created: 12/27/2003  -  Donnica Moore, M.D.

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