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What Is Chronic Pancreatitis?

Chronic pancreatitis is an on-going inflammatory condition that causes permanent and irreversible 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 upper abdominal pain, which may radiate to the back.  The pain is often accompanied by nausea, vomiting, weight loss, experience diarrhea, lost appetite, and diabetes or vitamin deficiencies.  The pain can occur daily or only sporadically; it can vary in severity.  The pain is usually worsened by eating a high-fat meal or by drinking alcohol.  It usually takes several years for permanent changes and symptoms to occur. Most cases are caused by severe or continued alcohol abuse, but other causes include heredity; gallstone or other blockages of the duct draining the pancreas; tumors; or cystic fibrosis.  

There is no single test to diagnose chronic pancreatitis. Numerous tests need to be conducted to rule out pancreatic cancer, blocked bile ducts or other causes of pancreatitis.  Tests that may be performed include:

  • Blood amylase and lipase levels. These two enzymes are typically elevated in people with acute pancreatitis and in many patients with chronic pancreatitis

  • Computed tomography (CT) scan (a three-dimensional X-ray of the soft tissues of the body) or ultrasound imaging can detect inflammation, ascites (fluid accumulation), scarring, and possible tumors of the pancreas

  • Endoscopic retrograde cholangiopancreatography (ERCP) is a test in which a dye is injected into the bile duct and pancreatic duct so that any blockages or damage will appear on an X-ray

There is no specific treatment for chronic pancreatitis.  Management is directed toward relieving pain, improving food absorption, and treating diabetes.  Pain is generally treated with over-the-counter pain relievers such as acetaminophen (Tylenol TM) or ibuprofen (e.g. Motrin, Advil, or Nuprin).  Related problems or symptoms can also be treated. 

As with most conditions, preventive strategies are central for proper disease management.  Alcohol should be strictly avoided.   Malabsorption, and the resulting vitamin deficiencies, can be treated by taking supplemental digestive enzymes in pill or capsule form. Some patients may benefit from a low carbohydrate, high protein diet with some restrictions on the type of fats that can be eaten. Once digestive problems are treated, people usually gain back weight and diarrhea improves.  Diabetes is treated with careful attention to diet to help keep blood-sugar levels stable. In some people, insulin injections are needed.

Created: 1/23/2004  -  Donnica Moore, M.D.

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