Health Encyclopedia

Chronic pancreatitis

Definition

Chronic pancreatitis is swelling (inflammation) of the pancreas that leads to scarring and loss of function. The pancreas is an organ located behind the stomach that produces chemicals needed to digest food. It also produces the hormones insulin and glucagon.

Causes, incidence, and risk factors

Chronic pancreatitis causes inflammation and scarring of tissue in the pancreas. This makes the pancreas unable to produce the right amount of chemicals (enzymes) needed to digest fat. It also interferes with insulin production, which may lead to diabetes.

The condition is most often caused by alcoholism and alcohol abuse. Sometimes the cause cannot be determined, however. Genetic causes have become more common. Other conditions have also been linked to chronic pancreatitis, such as:

Chronic blockage of the pancreatic duct
Injury
Hyperlipidemia
Hyperparathyroidism

Chronic pancreatitis occurs more frequently in men than in women. This may be because alcohol-use disorders are more common in men.

Symptoms

Abdominal pain
- Greatest in the upper abdomen
- May last from hours to days
- Eventually may be continuous
- May be worsened by eating or drinking
- May be worsened by drinking alcohol
- May spread (radiate) to the back
Digestive problems
Fatty stools
Nausea and vomiting
Pale or clay-colored stools
Unintentional weight loss

The symptoms may become more frequent as the condition gets worse. The symptoms may mimic pancreatic cancer. Sitting up and leaning forward may sometimes relieve the abdominal pain of pancreatitis.

Signs and tests

Tests for pancreatitis include:

Inflammation or calcium deposits of the pancreas may be seen on:

An exploratory laparotomy may be done to confirm the diagnosis of pancreatitis.

Treatment

The goal of treatment is to:

Prevent indigestion
Reduce pain
Reduce stimulation of the pancreas
Treat diabetes (if present)

Treatment may involve:

Analgesics or surgical nerve block to relieve pain
Eating a low-fat diet
Getting enough vitamins and calcium in the diet
Taking insulin to control blood sugar levels
Taking supplemental pancreatic enzymes

Do not drink alcohol.

Surgery may be recommended if a blockage is found. In severe cases, part or all of the pancreas may be removed.

Expectations (prognosis)

This is a serious disease that may lead to disability and death. You can reduce the risk by avoiding alcohol.

Complications

Ascites
Blockage (obstruction) of the small intestine or bile ducts
Blood clot in the vein of the spleen
Fluid collections in the pancreas (pancreatic pseudocysts) that may become infected
Poor function of the pancreas
- Diabetes
- Fat malabsorption

Calling your health care provider

Call for an appointment with your health care provider if:

You develop symptoms of pancreatitis
You have pancreatitis and your symptoms worsen or do not improve with treatment

Prevention

Determining the cause of acute pancreatitis and treating it promptly may help to prevent chronic pancreatitis. Avoiding heavy consumption of alcohol dramatically reduces the risk of developing this condition.

References

Nair RJ, Lawler L, Miller MR. Chronic pancreatitis. Am Fam Physician. 2007;76:1679-1688.

Review Date:5/27/2008
Reviewed By:Christian Stone, MD, Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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