Chronic pancreatitis

What is chronic pancreatitis?

An inflammation of the pancreas that does not heal or improve and gets worser and worser leading to permanent damage of the pancreas is called as Chronic pancreatitis.

Causes of Chronic pancreatitis

The digestive enzymes attack the pancreas and nearby tissues causing more pain. Develops in people who are between 30 and 40 of age. The most common cause of chronic pancreatitis is heavy alcohol consumption. The chronic form of pancreatitis is triggered by an acute attack that damages the pancreatic duct. The damaged duct causes inflammation of the pancreas. This leads to the development of scar tissue which slowly destroys the pancreas.

Other causes of chronic pancreatitis are

• hereditary disorder— usually in persons younger than age 30

• cystic fibrosis—an inherited disorder leading to chronic pancreatitis

• hypercalcemia—high levels of calcium in the blood

• hyperlipidemia or hypertriglyceridemia—high levels of blood fats

• certain autoimmune diseases

• unknown causes

Episodes of abdominal pain and diarrhea that lasts for several days may progress to chronic pancreatitis. A diagnosis of hereditary pancreatitis is a must for a person who has two or more family members with pancreatitis in more than one generation.

Symptoms of chronic pancreatitis

An upper abdominal pain is experienced in most people with chronic pancreatitis although some people have no pain at all. The pain spreads to the back and feels worse when eating or drinking, and become constant and disables the affected person. In some cases, abdominal pain is not experienced as the condition worsens because the pancreas is no longer making digestive enzymes.

Other symptoms include

• nausea

• vomiting

• weight loss

• diarrhea

• oily stools

People with chronic pancreatitis often loses weight because the body does not secrete enough pancreatic enzymes for them to digest food, so the nutrients are not absorbed normally. Poor digestion may lead to malnutrition due to excretion of fat in the stool, a condition called as steatorrhea.

Complications of chronic pancreatitis

1. Development of sudden bouts of severe abdominal pain.

2. Formation of gallstones, pseudocysts, and narrowing or obstruction of the ducts.

3. Calcification of the pancreas, i.e., the pancreatic tissue hardens from deposits of insoluble calcium salts.

4. In advanced stages surgery may be necessary to remove part of the pancreas.

5. When the pancreatic tissue is destroyed the beta cells, the insulin-producing cells of the pancreas are also damaged, thus, leading to diabetes.

Diagnosis of chronic pancreatitis

1. Medical history and physical examination.

2. Blood tests.

3. Routine urine tests.

4. Stool tests.

5. An X-ray of the abdomen.

6. Abdominal ultrasound.

7. CT scan.

8. EUS.

9. MRCP.

Treatment of chronic pancreatitis

1. Hospitalization for pain management, IV hydration, and nutritional support.

2. Nasogastric feedings are recommended for patients with chronic pancreatitis, if the person continues to lose weight.

3. Administration of synthetic pancreatic enzymes, if the pancreas are not able to secrete enough enzyme on its own. These enzymes are taken with every meal to help the person digest food and regain some weight.

4. A nutritious diet that is low in fat. This includes small, frequent meals.

5. Drinking plenty of fluids and limiting the consumption of caffeinated beverages is also recommended.

6. A person with chronic pancreatitis is strongly advised not to smoke or consume alcoholic beverages, even if the pancreatitis is mild or in the early stages.

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