Long-term inflammation of the pancreas, leading to progressive loss of function
- Most common between the ages of 35 and 45
- Excessive alcohol consumption is a risk factor
- Gender and genetics are not significant factors
Chronic pancreatitis is a progressive disorder in which the pancreas is persistently inflamed. One of the functions of the pancreas is to secrete a fluid containing digestive enzymes that is added to the intestinal contents. The pancreas also forms the hormones insulin and glucagon, which are released into the bloodstream to control blood sugar levels. In chronic pancreatitis, normal pancreatic tissue becomes damaged and is replaced by scar tissue, gradually impairing pancreatic function. The condition is usually painful and may lead to complications. Damage to the pancreas is usually irreversible.
What are the causes?
About 7 in 10 cases of chronic pancreatitis are due to long-term alcohol abuse. In most other cases, the causes are unknown. In a few cases, chronic pancreatitis may be associated with cystic fibrosis or certain rare genetic conditions.
What are the symptoms?
Symptoms of chronic pancreatitis usually develop over several years and vary in severity depending on the extent of damage to the pancreas. Most people do not experience symptoms during the early stages, but, as the disease progresses, they may develop symptoms such as:
Persistent upper abdominal pain, often radiating to the back.
Nausea and vomiting.
Loss of appetite.
Complications result mainly from the reduced production of enzymes and hormones. A reduced level of pancreatic enzymes causes malabsorption, which may lead to greasy, bulky stools, vitamin deficiencies, and weight loss. Diabetes mellitus may result if the production of insulin is reduced.
How is it diagnosed?
There is no simple test to diagnose chronic pancreatitis. Your doctor may arrange for X-rays, ultrasound scanning, or MRI to look for calcium deposits in the pancreas, which are an indication that the pancreas has been inflamed. Other tests may include ERCP, in which a tube-like instrument called an endoscope is used to inject a contrast dye into the pancreatic duct to look for abnormalities. You may also have ultrasound scanning, which may be done through an endoscope, to look for gallstones. In addition, you may have blood tests to determine blood sugar levels.
What is the treatment?
Your doctor will probably advise you to avoid alcohol and fatty foods. You may need drugs to replace the hormones and enzymes that should be produced by the pancreas. Enzymes in tablet or powder form can be taken with each meal to aid digestion. Regular injections of insulin may also be necessary to control blood sugar levels and will probably be needed for life. If pain is severe, strong opiate painkillers are given. In some cases, pain may be relieved by a nerve block. In this procedure, an injection is used to destroy the nerves that carry pain sensations from the pancreas to the spinal cord.
What is the prognosis?
The symptoms of chronic pancreatitis may recede over time, but in some cases the disorder worsens and symptoms become more severe. People who have chronic pancreatitis are more likely to develop pancreatic cancer.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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