(Inflammation of Pancreas)
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.
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 pancreas to intenstines (called ducts) due to:
- 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)
- Autoimmune diseases like lupus
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
- Family history of hyperparathyroidism associated with chronic pancreatitis
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
- Weight loss
- Fatty stools
- Diabetes (elevated blood sugar) may result from damage to the pancreas cells that make insulin.
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
Talk with your doctor about the best treatment plan for you. Treatment options include:
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.
Your doctor will advise you to stop drinking alcohol as this is the most important intervention. Your doctor will also suggest you restrict the amount of fat in your diet.
If your pain is severe, surgery to drain an enlarged pancreatic duct or remove part of the pancreas may be necessary.
National Institute of Diabetes and Digestive and Kidney Diseases
National Pancreas Foundation
Canada Health Portal
Canadian Society of Intestinal Research
Chronic pancreatitis. DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Accessed July 5, 2007.
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.
Last reviewed November 2009 by ]]>B. Gabriel Smolarz, MD ]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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