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What Is Chronic Pancreatitis?

The pancreas is a gland in the abdomen (belly), surrounded by the stomach, intestines, and other organs. It makes substances called pancreatic juices (containing digestive enzymes) and the hormones insulin and glucagon.

Pancreatitis is inflammation (swelling) of the pancreas. It occurs when these digestive enzymes begin attacking the pancreas. Pancreatitis can be acute (occurs suddenly). Continuing injury to the pancreas may lead to a long-lasting (chronic) form. Chronic pancreatitis is inflammation and scarring of the pancreas that occurs over a long period. The pancreas doesn’t make its enzymes, causing an inability to digest and absorb fat in the diet. Insulin production also decreases.

Chronic pancreatitis isn’t common. More men than women are affected. Pancreatitis cannot be caught.

What Causes Chronic Pancreatitis?

Alcohol abuse is the major cause. Other causes are hemochromatosis (too much iron in the blood) and cystic fibrosis. Sometimes the cause is unknown.

What Are the Symptoms of Chronic Pancreatitis?

The most common symptom is pain in the mid- and upper back and abdomen that varies in intensity. It may be a lowgrade, lasting pain with repeated acute attacks. The pain may be constant and severe.

Another symptom is weight loss, which occurs because the body cannot absorb fat properly (malabsorption). Large, foul, bulky bowel movements, or stools (called steatorrhea) occur because of this problem with fat absorption. People can also have a distended abdomen and jaundice (yellowing of skin) in severe cases.

How Is Chronic Pancreatitis Diagnosed?

The health care provider diagnoses chronic pancreatitis by reviewing the medical history and doing a physical examination. Samples of blood are studied for signs of this disease. A CT scan or ultrasound of the abdomen may also be done to exclude other causes of your symptoms.

How Is Chronic Pancreatitis Treated?

The first treatment goal is to manage pain, usually by using nonnarcotic pain relievers. Referral to a pain specialist may help. In rare cases, if pain cannot be controlled, surgery is a possibility. Surgery involves draining the pancreatic duct (tube connecting the pancreas and bile duct). In advanced cases, all or part of the pancreas can be removed.

The second goal is replacing digestive enzymes and insulin that the pancreas normally makes. In severe cases, insulin replacement may also be necessary. Pancreatic enzymes, as tablets, are taken with meals and snacks. Insulin injections are used to control the high blood sugar (glucose) level if present. Supplements of vitamins A, D, and K may be needed because of poor absorption.

DOs and DON’Ts in Managing Chronic Pancreatitis:

  • DO eat a low-fat, well-balanced diet.
  • DO take oral fat-soluble vitamin supplements and calcium supplements.
  • DO take pancreatic enzyme supplements as prescribed.
  • DO call your health care provider if you cannot control pain with prescribed drugs. See a pain specialist if pain control is difficult.
  • DO call your health care provider if you get symptoms of pancreatitis or symptoms worsen or don’t improve with treatment.
  • DO call your health care provider if you get jaundice.
  • DON’T eat fatty foods.
  • DON’T drink alcohol or caffeinated beverages.
  • DON’T use narcotics for pain control for long periods.
FOR MORE INFORMATION

Contact the following sources:

  • American Gastroenterological Association
    Tel: (301) 654-2055
    Website: http://www.gastro.org
  • National Digestive Diseases Information Clearinghouse
    Tel: (800) 891-5389
    Website: http://www.niddk.nih.gov/health/digest/nddic.htm

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor