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 Disease Of The Pancreas >
Chronic Pancreatitis
Click on the question of interest to go to the answer.
What
is Chronic Pancreatitis?
What are the symptoms of Chronic Pancreatitis?
What procedures are used to diagnosis Chronic Pancreatitis?
What causes Chronic Pancreatitis?
What treatment options are there for Chronic Pancreatitis?
What is the prognosis for Chronic Pancreatitis?
About
Chronic Pancreatitis
Chronic pancreatitis is an
ongoing inflammation of the pancreas, an organ located behind the
stomach. This progressive disorder associated with the
destruction of the pancreas may be confused with acute pancreatitis
due to the similarities of the symptoms.
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 Symptoms
of Chronic Pancreatitis
Upper abdominal pain and back
pain with nausea and vomiting are the main symptoms of chronic
pancreatitis. As the disease becomes more chronic, patients may
develop malnutrition, weight loss and insulin-dependent diabetes.
The pain is usually a constant,
dull pain that gets worse with eating food or drinking alcohol and
lessens when sitting up and leaning forward. As the disease
progresses, attacks last longer and happen more often. Attacks can
last only few hours or as long as several weeks.
 If a large area of the pancreas
is damaged, its enzymes are not produced and can't reach the
intestines. As a result, food and nutrients are poorly absorbed.
Bowel movements become frequent and foul smelling because of
problems with fat absorption.
If the pancreas is unable to
produce the hormone insulin, these symptoms of diabetes mellitus
may develop:
•
increased thirst
• increased appetite
• increased urination
• fatigue
• weight loss.
If you have any of these signs
with abdominal pain, see your doctor immediately.
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Diagnosis
of Chronic Pancreatitis
The diagnosis of chronic
pancreatitis is difficult because routine blood studies (such as
amylase and lipase levels) do not necessarily show elevations. The
most important clue to a proper diagnosis is an accurate medical
history. There are many diagnostic tests that can be used for
chronic pancreatitis. The evaluation should begin with a plain
film of the abdomen. The finding of pancreatic calcification is
virtually diagnostic of chronic pancreatitis but quit often this
is not found. Tests
the doctor may use to confirm the diagnosis include:
Ultrasonography
- This method uses high-frequency sound
waves that are above the human audible range. An instrument sends
sound waves into the patient’s abdomen, and the echoes that the
sound waves produce as they bounce off internal organs creates a
picture called a sonogram.
CT
scanning (Computed Tomography) -This
method of testing involves the use of an x-ray machine which is
linked to a computer. The patient lies on a bed that passes
through a hole, and the machine moves along the patient’s body,
simultaneously taking multiple x-rays. The computer then pieces
the x-rays together to produce detailed pictures.
ERCP
(Endoscopic retrograde cholangiopancretography) -A
method for taking x-rays of the common bile duct and the
pancreatic ducts. The doctor passes a long, flexible tube called
an endoscope down the throat, through the stomach, and into the
small intestine. The doctor then injects dye into the ducts and
takes x-rays.
EUS
(Endoscopic Ultrasound) - This
is a test that combines ultrasound(sound waves) with an endoscope.
The doctor places the tube (endoscope) into the stomach and the
ultrasound machine (which is on the endoscope) is used to direct
sound waves to the pancreas.
MRI
(Magnetic Resonance Imaging) -
This method of testing involves the use of
an x-ray machine which is linked to a computer. The patient lies
on a bed that passes through a hole, and the machine moves along
the patient’s body, simultaneously taking multiple x-rays. The
computer then pieces the x-rays together to produce detailed
pictures.
In addition to glucose
tolerance test, a test to measure damage to the cells in the
pancreas that make insulin and a biopsy, an exam of tissue removed
from the pancreas.
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Causes,
incidence, and risk factors of
Chronic Pancreatitis
Drinking too much alcohol is
the most common cause of chronic pancreatitis. Because of the
effects of chronic pancreatitis, the damaged pancreas becomes less
able over time to produce normal digestive enzymes and hormones.
Chronic pancreatitis may also
result from:
•
excess lipids in the blood
• gallstones, which block the flow of pancreatic secretions into
the intestines
• heredity, in rare cases.
The disease affects men more
often than women. Alcohol abuse is an important risk factor.
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Treatment
of
Chronic Pancreatitis
The treatment for chronic
pancreatitis depends on the symptoms. However, most
therapies centers focus on pain management and nutritional
support. Oral pancreatic enzyme supplements are utilized to aid in
the digestion of food. Patients who develop diabetes require
insulin to control the blood sugar. It is important to remember
that no treatment will help relieve your pain if you drink
alcohol. A diet low in fat is necessary and sometimes it is easier
for the patient to eat more frequently in much smaller portions.
The doctor may recommend surgery to relieve abdominal pain, to
restore drainage of pancreatic secretions, or to reduce the
frequency of attacks.
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Prognosis
of
Chronic Pancreatitis
As with any
chronic disease, the effects may last for months or years. If you
avoid alcohol completely, follow your diet, and take the
medication prescribed by the doctor, your chances for improvement
are good. In addition, follow the diet and take the
medications the doctor prescribes to help your pancreas heal.
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lori.hagerty@ucphysicians.com