• Chronic Pancreatitis

    (Inflammation of Pancreas)

    Definition

    The pancreas, a six-inch long organ below the stomach, makes enzymes and hormones that aid in digestion and balance the body’s sugar content. Enzymes break down the food we eat as it passes into the intestines and the pancreatic hormones, primarily insulin and glucagon, regulate sugar metabolism.
    Chronic pancreatitis occurs when the organ’s digestive enzymes attack and destroy the pancreas itself and nearby tissues, resulting in decreased enzyme and hormone release, scarring, and pain.
    Pancreatitis
    Nuclus factsheet image
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Chronic pancreatitis results from prolonged injury to the pancreas, usually caused by prolonged alcohol abuse. Other causes include:
    • Heredity Cystic fibrosis
    • Obstruction of the passageway from the pancreas to the intestines due to:
      • Trauma
      • Gallstones
      • Tumors
      • Pseudocysts (accumulation of fluids and debris)
    • Congenital conditions (eg, pancreas divisum)
    • Tropical pancreatitis
    • Hypercalcemia (high blood levels of calcium)
    • Hyperlipidemia or hypertriglyceridemia (high levels of blood fats)
    • Medications
    • Autoimmune diseases like lupus

    Risk Factors

    A risk factor is something that increases your chance of getting a disease or condition.
    Factors that may increase your risk of chronic pancreatitis include:
    • Gender: male
    • Age: late teens to mid-twenties (for alcohol-induced)
    • Age: over 50 (for cases of no known cause)
    • Heavy alcohol consumption
    • Smoking
    • Family history of hyperparathyroidism associated with chronic pancreatitis
    Chronic pancreatitis is a risk factor for developing pancreatic cancer.

    Symptoms

    Symptoms associated with chronic pancreatitis include:
    • Abdominal pain that may get worse when eating or drinking, spread to the back, or become constant and disabling
    • Nausea
    • Vomiting
    • Weight loss
    • Fatty stools
    • Diabetes (elevated blood sugar) may result from damage to the pancreas cells that make insulin.

    Diagnosis

    The diagnosis of chronic pancreatitis is difficult. Symptoms are not specific early on in the course of the disease.
    Your doctor will ask about your symptoms and medical history, and perform a physical exam. Other tests may include:
    • Endoscopic retrograde cholangiopancreatography (ERCP)—the combined use of x-ray and endoscopy used to examine the pancreas. This is generally the test of choice.
    • Ultrasound —a test that uses sound waves from outside the body to make pictures of the inside body tissues. There is no radiation involved.
    • Abdominal X-ray —a test that uses radiation to take a picture of structures inside the body
    • CT Scan —a type of x-ray that uses the computer to make pictures of structures inside the body
    • MRI scan —a test that uses magnetic fields to make computerized pictures of the brain (No radiation is delivered with an MRI.)
    • Blood tests are usually normal
    • Stool tests—72 hour fecal fat

    Treatment

    Talk with your doctor about the best treatment plan for you. Treatment options include:

    Medications

    Pain associated with chronic pancreatitis can be controlled with medications (eg, tramadol ). If the pancreas does not secrete enough enzymes, your doctor may prescribe pancreatic enzymes that you will take with meals. In addition, insulin or other medications may be needed to control blood glucose.

    Diet

    Your doctor will advise you to stop drinking alcohol. This is the most important intervention.
    Your doctor may also suggest that you restrict the amount of fat in your diet. Pancreatic damage interferes with body's ability to process fats. If you do need to change your diet, it may be hard for you to maintain your normal weight. A registered dietician can work with you and create a healthy meal plan.

    Surgery

    If your pain is severe, surgery to drain an enlarged pancreatic duct or remove part of the pancreas may be necessary.

    Prevention

    Take the following steps to prevent chronic pancreatitis:
    • Diagnose and treat cases of acute pancreatitis as early as possible.
    • Avoid alcohol.

    RESOURCES

    National Institute of Diabetes and Digestive and Kidney Diseases http://www2.niddk.nih.gov

    National Pancreas Foundation http://www.pancreasfoundation.org

    CANADIAN RESOURCES

    Canada Health Portal http://www.hc-sc.gc.ca/

    Canadian Society of Intestinal Research http://www.badgut.com

    References

    Chronic pancreatitis. DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Accessed July 5, 2007.

    Grant JP. Nutritional support in acute and chronic pancreatitis. Surg Clin North Am. 2011;91(4):805-20, viii.

    Pancreatitis. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/pancreatitis/#chronic . Accessed July 5, 2007.

    Singh VV, Toskes PP. Medical therapy for chronic pancreatitis pain. Curr Gastroenterol Rep. 2003; 5:110.

    Revision Information

  • Join WellZones today.

    Make a Change For LifeLearn more

    Wellmont LiveWell is creating a new tradition of wellness in the mountains by providing individuals with tools and encouragement to live healthier lifestyles.

  • HeartSHAPE Spotlight

    HeartSHAPE® Test Learn more

    Fight heart disease early and prevent heart attacks with HeartSHAPE® - a painless, non-invasive test that takes pictures of your heart to scan for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.


  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.