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.
