Chronic Pancreatitis

Introduction

Chronic pancreatitis is a medical condition in which the pancreas is persistently inflamed over a long period.

The pancreas is a soft, elongated gland situated at the back of the upper abdominal cavity, behind the stomach. This organ produces chemicals needed to digest food (digestive enzymes), along with the hormone insulin and glucagon.

Key Symptoms

The abdominal pain in chronic pancreatitis has its own set of typical symptoms. Here we list a few main characteristics of abdominal pain in this condition:

Greatest in the upper abdomen

May last from hours to days

Eventually may be continuous

May worsen with eating or drinking

May worsen with alcohol consumption

May radiate to the back

Other symptoms of chronic pancreatitis include:

Diabetes

Nausea and vomiting

Vomiting after meals

Poor pancreatic function

Unintentional weight loss

Fatty stools

Pale or clay-colored stools

Causative Factors

Long-term excessive alcohol consumption is the most common cause of chronic pancreatitis. In fact, the risk of developing chronic pancreatitis is directly associated to the amount of alcohol consumed.

Other main causes of chronic pancreatitis include:

High levels of calcium in the blood

Abnormalities in anatomy present at birth

Blocked or narrowed pancreatic duct due to trauma or pseudocysts

Systemic disease, such as cystic fibrosis

Heredity

High blood fats or Hypertriglyceridaemia

Side effects of drugs

No specific cause known (idiopathic pancreatitis)

Diagnostic Tools

A series of tests are carried out to confirm the presence of chronic pancreatitis. Here we briefly list each one of them:

Blood Tests: These can confirm the presence of digestive enzymes that have leaked out of the pancreas into the bloodstream when the pancreas in inflamed. The two most common tests are the serum amylase test and the serum lipase test.

Stool test: These tests detect steatorrhea, which are the abnormal levels of fat in a stool sample.

Imaging tests: These provide information regarding the structure of pancreas, the ducts that drain the pancreas and gallbladder and the surrounding tissues. The main tests are:

X-rays

Ultrasound

CT scans

MRI scans

Endoscopic retrograde cholangiopancreatography (ERCP)

Endoscopic ultrasound

Magnetic resonance cholangiopancreatography (MRCP)

Pancreatic function tests

Secretion stimulation test

Bentiromide test

Tests for pancreatic cancer are also carried out in this health condition.

Treatment Options

Treatment of chronic pancreatitis is aimed at relieving pain accompanied with more severe measures in the later stages of treatment. The main treatment options include:

Avoiding alcohol

Modifying meals

Narcotic analgesics

Non-narcotic analgesics

Insulin to control blood sugar levels

Pancreatic enzyme supplements

Injections for nerve block

Treatments to widen pancreatic ducts

Pancreatic lithotripsy

Surgical procedures