Health Encyclopedia

Chronic pancreatitis

Definition

Chronic pancreatitis is ongoing inflammation of the pancreas. The pancreas is an organ located behind the stomach that produces chemicals needed to digest food, as well as 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.

Persons with chronic pancreatitis have attacks of abdominal pain and digestive problems. The symptoms may become more frequent as the condition gets worse. The symptoms may mimic pancreatic cancer.

The condition is most often caused by alcoholism and alcohol abuse, but sometimes the cause cannot be determined. Genetic causes are become more common. Conditions such as hyperlipidemia or hyperparathyroidism, injury, and chronic blockage of the pancreatic duct are also linked to chronic pancreatitis.

Chronic pancreatitis occurs more frequently in men than in women, perhaps 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 alcohol consumption
- May radiate to the back
Nausea and vomiting
Unintentional weight loss
Fatty stools

Sitting up and leaning forward may sometimes relieve the abdominal pain associated with pancreatitis.

Pale or clay-colored stools may also be associated with this condition.

Signs and tests

Serum lipase may be higher than normal, but can return to normal as the disease gets worse.
Serum amylase may be higher than normal, but can return to normal as the disease gets worse.
Serum trypsinogen may be low.
Fecal fat test shows fatty stools.

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

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

Treatment

The goal of treatment is to reduce stimulation of the pancreas, prevent indigestion, reduce pain, and treat diabetes (if present). Treatment may involve:

Eating a low-fat diet
Getting enough fat-soluble vitamins and calcium in the diet
Analgesics or surgical nerve block to relieve pain
Insulin to control blood sugar levels
Supplemental pancreatic enzymes to correct underproduction

Patients must 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. The risk of death may be lowered the person continues to avoid alcohol.

Complications

Obstruction of the small intestine or bile ducts
Pancreatic insufficiency
- Diabetes
- Fat malabsorption
Ascites
Pancreatic pseudocysts (fluid collections), which may become infected
Blood clots in the splenic vein

Calling your health care provider

Call for an appointment with your health care provider if you develop symptoms of pancreatitis.

Call for an appointment with your provider if 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.

Review Date:7/25/2006
Reviewed By:Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-TorresdaleHospital, Jefferson Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

ADAM Quality A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial process. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.

Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.