Chronic pancreatitis

Pancreatitis is a condition in which the pancreas (a gland that lies behind the stomach and next to the small intestine) becomes inflamed. Chronic pancreatitis (CP) occurs when there is lifelong, ongoing inflammation of the pancreas. Its most common manifestation is pain. At its later stages, it may result in loss of pancreas function; specifically, the pancreas is unable to produce enough enzymes to digest food or enough insulin to regulate blood sugar.

At the Comprehensive Pancreas and Disease Center, our multidisciplinary experts collaborate to ensure that patients receive the highest quality care. We have an extensive team of specialists with vast experience in pancreas diseases, who can perform leading-edge surgical procedures and leverage all possible innovations to provide the highest level of treatment and care. As a patient-focused Center, we’re continuously involved in clinical research to bring the latest advances in treatment to our patients.

CP is widely characterized by chronic pain that is generally in the upper abdomen and radiates to the back. The pain can be more intense after eating, especially after consuming large meals or fatty foods. The pain generally becomes more frequent and severe as the disease progresses; some patients experience constant abdominal pain.

Additional symptoms may include:

• Nausea and vomiting, often experienced during episodes of pain
• Steatorrhea (loose, oily and foul smelling stools), due to the inability of the pancreas to absorb fat
• Bloating, abdominal cramps and gas
• Diabetes mellitus

In 15 percent of cases, CP can be a result of prior episodes of acute pancreatitis. However, the majority of CP cases occur without prior history. It can be caused by:

• Long standing alcohol abuse
• Hereditary disorders
• Pancreatic duct strictures
• Autoimmune conditions
• Cystic fibrosis and other genetic disorders
• Trauma to the pancreas
• Idiopathic (unknown) reasons

Over time, CP can lead to other problems such as diabetes, malnutrition and bile duct obstruction. CP patients also have a significantly increased risk of developing pancreatic cancer compared to the general population: the risk can be 15 to 40 times higher, depending on the cause of their CP.

CP is usually diagnosed by:

• Laboratory tests: Such as lipase and amylase levels
• Transabdominal computed tomography scan (CT scan): A CT scan combines a sequence of X-ray images from different angles of the body and uses computer processing to create more detailed information than X-rays do
• Magnetic Resonance Imaging (MRI): A test that uses a magnetic field and radio waves to generate detailed images of the patient’s organs. The test produces images of body parts by injecting dye into the veins that helps show the pancreas, gallbladder, and pancreatic and bile ducts
• Magnetic resonance cholangiopancreatography (MRCP): A vital test that can show information on the pancreatic duct and any fluid collections
• Endoscopic procedures: Such as endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS)
• Other tests as needed: Depending on the suspected cause of pancreatitis

CP patients can experience acute flares of inflammation and pain requiring hospitalization. Treatment may include the following procedures and courses of action:

• Pain management: Patient will receive pain medication, as well as medication to ease nausea
• Frequent blood tests: To monitor electrolytes and kidney function
• Pancreatic enzymes: To take with meals to help digestion and absorption of food. May also help the symptoms of fatty diarrhea and abdominal bloating
• Avoiding alcohol: If the pancreatitis is caused by alcohol usage
• Avoiding smoking: This will help your body heal
• Surgery: When necessary, there are advanced procedres that can be performed

For CP patients. the risk of mortality is almost four times higher than the general population. Up to 50 percent of CP patients are either disabled or unemployed because of the effects of their disease. CP is a serious disease, and it’s important to seek treatment from qualified professionals.