The pancreas is a six-inch long organ below the stomach. It makes enzymes and hormones that aid in digestion and balance the body’s sugar content. Enzymes break down the food we eat as it passes into the intestines. The pancreatic hormones, primarily insulin and glucagon, regulate sugar metabolism.
Chronic pancreatitis occurs when the organ’s digestive enzymes attack and destroy the pancreas and nearby tissues, resulting in decreased enzyme and hormone release, scarring, and pain.
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Chronic pancreatitis results from prolonged injury to the pancreas, usually caused by prolonged alcohol abuse. Other causes include:
Obstruction of the passageway from the pancreas to the intestines due to:
TraumaGallstonesTumorsPseudocysts—build up of fluids and debrisCongenital conditions such as pancreas divisumTropical pancreatitisHypercalcemia—high blood levels of calciumHyperlipidemia
or hypertriglyceridemia—high levels of blood fatsMedicationsAutoimmune diseases like lupus
Factors that may increase your risk of chronic pancreatitis include:
Gender: maleAge: late teens to mid-twenties—for alcohol-inducedAge: over 50—for cases of no known causeHeavy alcohol consumptionSmokingFamily history of hyperparathyroidism associated with chronic pancreatitis
Chronic pancreatitis is a risk factor for developing pancreatic cancer.
Symptoms associated with chronic pancreatitis include:
Abdominal pain that may get worse when eating or drinking, spread to the back, or become constant and disablingNauseaVomitingWeight loss
The diagnosis of chronic pancreatitis is difficult. Symptoms are not specific early on in the course of the disease.
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Your bodily fluids and waste may be tested. This can be done with: Blood tests Stool tests
Images may be taken of your bodily structures. This can be done with: Endoscopic retrograde cholangiopancreatography (ERCP)Ultrasound
X-rayCT ScanMRI scan
Talk with your doctor about the best treatment plan for you. Treatment options include:
Pain associated with chronic pancreatitis can be controlled with medications. If the pancreas does not secrete enough enzymes, your doctor may prescribe pancreatic enzymes that you will take with meals. In addition, insulin or other medications may be needed to control blood glucose.
Your doctor will advise you to stop drinking alcohol. This is the most important intervention.
Your doctor may also suggest that you restrict the amount of fat in your diet. Pancreatic damage interferes with the body's ability to process fats. If you do need to change your diet, it may be hard for you to maintain your normal weight. A registered dietitian can work with you and create a healthy meal plan.
If your pain is severe, surgery to drain an enlarged pancreatic duct or to remove part of the pancreas may be necessary.
Avoid excessive alcohol consumption to help prevent chronic pancreatitis.
Grant JP. Nutritional support in acute and chronic pancreatitis.
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Singh VV, Toskes PP. Medical therapy for chronic pancreatitis pain.
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Last reviewed August 2013 by Lawrence Frisch, MD, MPH; Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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