The pancreas is a long, flat, pear-shaped organ located behind the stomach. It makes digestive enzymes and hormones, including insulin. Chronic pancreatitis is a progressive inflammation of the pancreas marked by frequent acute attacks and risk of permanent organ damage.
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Chronic pancreatitis results from prolonged injury, toxic exposure, autoimmune disease, or obstruction of the pancreas.
Chronic pancreatitis is more common in men. Other factors that may increase your risk of chronic pancreatitis include:
Personal health history, such as: Excess alcohol intakeSmoking
Recurrent attacks of acute pancreatitisFamily history of: hyperparathyroidism associated with chronic pancreatitischronic pancreatitishypercalcemia
Chronic kidney diseaseCongenital conditions, such as pancreas divisumIschemia—insufficient blood supply to the pancreasHyperlipidemia—elevated blood fat levelsHypertriglyceridemia—elevated blood
levelsHypercalcemia—elevated blood calcium levelsCystic fibrosis
Conditions that obstruct the passageway from the pancreas to the small intestine include: TraumaTumorsPseudocysts—build up of fluids and debris
Chronic pancreatitis is a risk factor for developing pancreatic cancer.
Symptoms may be mild, but progressive.
Chronic pancreatitis may cause:
Abdominal pain that: may get worse when eating or drinking, spreading to the back, or become constant and disabling Spreads to the backGets worse when eating or drinkingBecomes constant or disablingNausea and vomitingWeight lossDiarrhea—with presence of excess fat or nitrogen-based substances in the stool
The goals of treatment for chronic pancreatitis are to relieve pain and manage nutritional and metabolic problems.
Treatment may be started in a hospital until you are stabilized. Stabilization can be done with: IV fluidsNasogastric tube—A long, thin tube is threaded through your nose and into your stomach for feeding.
Your doctor may recommend: Prescription pain relieversPancreatic enzymesVitamin supplementsMedications to control diabetes if it develops
Your doctor will advise you to stop drinking alcohol. This may require counseling or a rehabilitation program. Stopping your alcohol intake is the most important intervention in your treatment.
If you smoke, talk to your doctor about how you can successfully quit.
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. A registered dietitian can work with you and create a healthy meal plan.
Surgery may be needed in severe cases: Necrosectomy—Removal of dying or dead (necrotic) pancreatic tissue. Pancreatic necrosis is more serious if an infection is present. This procedure can also be done with endoscopy. ECRP—To open any collapsed ducts or drain cysts.Cholecystectomy—To remove the gallbladder.
Aside from avoiding too much alcohol, there are no current guidelines to prevent chronic pancreatitis. If you have recurrent attacks or are at high risk for developing chronic pancreatitis, you can make other lifestyle changes that may reduce your risk.
Chronic pancreatitis. DynaMed website.
Updated April 22, 2013. Accessed December 4, 2013.
Chronic pancreatitis. Tulane University School of Medicine website. Available at: http://tulane.edu/som/pancreas-biliary/diseases/chronic-pancreatitis.cfm. Accessed December 4, 2013.
Grant JP. Nutritional support in acute and chronic pancreatitis.
Surg Clin North Am.
Pancreatitis. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
http://digestive.niddk.nih.gov/ddiseases/pubs/pancreatitis. Updated August 16, 2012. Accessed December 4, 2013.
Singh VV, Toskes PP. Medical therapy for chronic pancreatitis pain.
Curr Gastroenterol Rep.
Last reviewed December 2013 by 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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