Chronic Pancreatitis

Chronic pancreatitis is an inflammation of your pancreas that doesn”t improve over time.

The pancreas is an organ located behind your stomach. It makes enzymes, which are special proteins that help digest your food. It also makes hormones that control the level of sugar in your bloodstream.

Pancreatitis occurs when your pancreas becomes inflamed. Pancreatitis is considered acute when the inflammation comes on suddenly and only lasts for a short period of time. It”s considered chronic when it keeps coming back or when the inflammation doesn”t heal for months or years.

Chronic pancreatitis can lead to permanent scarring and damage. Calcium stones and cysts may develop in your pancreas, which can block the duct, or tube, that carries digestive enzymes and juices to your stomach. The blockage may lower the levels of pancreatic enzymes and hormones, which will make it harder for your body to digest food and regulate your blood sugar. This can cause serious health problems, including malnutrition and diabetes.

What Causes Chronic Pancreatitis?

There are numerous different causes of chronic pancreatitis. The most common cause is long-term alcohol abuse. Approximately 70 percent of cases are linked to alcohol consumption.

The main pancreatic duct connects with the common bile duct, which carries bile from the gallbladder, and together they connect with the duodenum at a point called the ampulla of Vater. Here, bile and pancreatic enzymes enter the duodenum to aid with the digestion of fats, carbohydrates and proteins.

Autoimmune disease occurs when your body mistakenly attacks your healthy cells and tissues. Inflammatory bowel syndrome, which is inflammation of the digestive tract, and primary biliary cholangitis, which is a chronic liver disease associated with chronic pancreatitis.

Other causes include:

• autoimmune disease, which occurs when your body mistakenly attacks your healthy cells and tissues
• a narrow pancreatic duct, which is the tube that carries enzymes from the pancreas to the small intestine
• a blockage of the pancreatic duct by either gallstones or pancreatic stones
• cystic fibrosis, which is a hereditary disease that causes mucus to build up in your lungs
• genetics
• high blood levels of calcium, which is called hypercalcemia
• a high level of triglyceride fats in your blood, which is called hypertriglyceridemia

Who Is at Risk for Getting Chronic Pancreatitis?

Abusing alcohol increases your risk of developing chronic pancreatitis. Smoking is believed to increase the risk of pancreatitis among alcoholics. In some cases, a family history of chronic pancreatitis can increase your risk.

Chronic pancreatitis most frequently develops in people between the ages of 30 and 40. The condition is also more common among men than women.

Children living in tropical regions of Asia and Africa may be at risk for developing tropical pancreatitis, which is another type of chronic pancreatitis. The exact cause of tropical pancreatitis is unknown, but it may be related to malnutrition.

What Are the Symptoms of Chronic Pancreatitis?

At first, you may not notice any symptoms. Changes in your pancreas can become quite advanced before you begin to feel unwell. When symptoms occur, they may include:

• pain in your upper abdomen
• diarrhea
• fatty stools, which are loose, pale, and don”t flush away easily
• nausea and vomiting
• shortness of breath
• unexplained weight loss
• excessive thirst and fatigue

You may experience more severe symptoms as the disease progresses, such as:

• pancreatic fluids in your abdomen
• jaundice, which is characterized by a yellowish discoloration in your eyes and skin
• internal bleeding
• intestinal blockage

Painful episodes can last for hours or even days. Some people find that eating or drinking can make their pain worse. As the disease progresses, the pain may become constant.

How Is Chronic Pancreatitis Diagnosed?

During the early stages of chronic pancreatitis, changes in your pancreas are difficult to see in blood tests. For this reason, blood tests typically aren”t used to diagnose the disease. However, they may be used to determine the amount of pancreatic enzymes in your blood. Blood tests may also be used to check blood cell counts along with kidney and liver function. Your doctor might ask you for a stool sample to test for levels of fat. Fatty stools could be a sign that your body isn”t absorbing nutrients correctly.

Imaging tests are the most reliable way for your doctor to make a diagnosis. Your doctor might request that the following studies be done on your abdomen to look for signs of inflammation:

• X-rays
• ultrasounds
• CT scans
• MRI scans

Your doctor may also recommend an endoscopic ultrasound. During an endoscopic ultrasound, your doctor inserts a long, flexible tube into your mouth and down through the stomach and small intestine. The tube contains an ultrasound probe, which emits sound waves that create detailed images of your pancreas.

How Is Chronic Pancreatitis Treated?

Treatment for chronic pancreatitis focuses on reducing your pain and improving your digestive function. The damage to your pancreas can”t be undone, but with the proper care, you should be able to manage many of your symptoms. Treatment for pancreatitis can include medication, endoscopic therapies, or surgery.

Medications

Possible medications that your doctor may prescribe for chronic pancreatitis include:

• pain medication
• artificial digestive enzymes if your enzyme levels are too low to digest food normally
• insulin if you have diabetes
• steroids if you have autoimmune pancreatitis, which occurs when your body”s immune system attacks your pancreas

Endoscopy

Some treatments use an endoscope to reduce pain and get rid of blockages. An endoscope is a long, flexible tube that your doctor inserts through your mouth. It allows your doctor to remove pancreatic stones, place small tubes called stents to improve flow, and close leaks.

Surgery

Surgery is not necessary for most people. However, if you have severe pain that isn”t responding to medication, removing part of your pancreas can sometimes provide relief. Surgery may also be used to unblock your pancreatic duct, drain cysts, or to widen it if it”s too narrow.

It”s important to avoid alcohol after you”ve been diagnosed with chronic pancreatitis, even if alcohol wasn”t the cause of your illness. You should also avoid smoking because it can increase your risk of developing pancreatic cancer. You may need to limit the amount of fat in your diet and take vitamins.

What Are the Possible Complications of Chronic Pancreatitis?

Chronic pancreatitis has the potential to cause numerous complications. You”re at greater risk of developing complications if you continue to drink alcohol after you”ve been diagnosed.

Nutrient malabsorption is one of the most common complications. Since your pancreas isn”t producing enough digestive enzymes, your body isn”t absorbing nutrients properly. This can lead to malnutrition.

The development of diabetes is another possible complication. Pancreatitis damages the cells that produce insulin and glucagon, which are the hormones that control the amount of sugar in your blood. This can lead to an increase in blood sugar levels. About 45 percent of people with chronic pancreatitis will get diabetes.

Some people will also develop pseudocysts, which are fluid-filled growths that can form inside or outside of your pancreas. Pseudocysts are dangerous because they can block important ducts and blood vessels. They may become infected in some cases.

Long-Term Outlook

The outlook depends on the severity and underlying cause of the disease. Other factors can affect your chances of recovery, including your age at diagnosis and whether you continue to drink alcohol or smoke cigarettes.

Prompt diagnosis and treatment can improve the outlook. Call your doctor right away if you notice any symptoms of pancreatitis.