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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Chronic pancreatitis

Last reviewed: February 10, 2014.

Chronic pancreatitis is inflammation of the pancreas that does not heal or improve, gets worse over time, and leads to permanent damage.

Causes

The pancreas is an organ located behind the stomach that produces chemicals (called enzymes) needed to digest food. It also produces the hormones insulin and glucagon.

When inflammation and scarring of the pancreas occur, the organ is no longer able to make the right amount of these enzymes. As a result, your body may be unable to digest fat and key elements of food.

Damage to the parts of the pancreas that make insulin may lead to diabetes.

The condition is most often caused by alcohol abuse over many years. Repeated episodes of acute pancreatitis can lead to chronic pancreatitis. Genetics may be a factor in some cases. Sometimes, the cause is not known.

Other conditions that have been linked to chronic pancreatitis:

Chronic pancreatitis occurs more often in men than in women. The condition often develops in people ages 30 - 40.

Symptoms

Abdominal pain:

  • Greatest in the upper abdomen
  • May last from hours to days
  • Eventually may be continuous
  • May get worse from eating or drinking
  • May get worse from drinking alcohol
  • May also be felt in the back

Digestive problems:

You may need an exploratory laparotomy may be done to confirm the diagnosis. This is more often done for acute pancreatitis.

Exams and Tests

Tests for pancreatitis include:

Inflammation or calcium deposits of the pancreas, or changes to the ducts of the pancreas may be seen on:

An exploratory laparotomy may be done to confirm the diagnosis, but this is usually done for acute pancreatitis.

Treatment

People with severe pain or who are losing weight may need to stay in the hospital for:

  • Pain medicines
  • Fluids given through a vein (IV)
  • Stopping food or fluid by mouth to limit the activity of the pancreas, and then slowly starting an oral diet
  • Inserting a tube through the nose or mouth to remove the contents of the stomach (nasogastric suctioning) may sometimes be done. The tube may stay in for 1 - 2 days, or sometimes for 1 - 2 weeks.

The right diet is important for people with chronic pancreatitis to keep a healthy weight and get the correct nutrients. A nutritionist can help you create a diet that includes:

  • Drinking plenty of liquids
  • Limiting fats
  • Eating small, frequent meals (this helps reduce digestive symptoms)
  • Getting enough vitamins and calcium in the diet, or as extra supplements
  • Limiting caffeine

The doctor may prescribe pancreatic enzymes. You must take these medicines with every meal. The enzymes will help you digest food better and gain weight.

Avoid smoking and drinking alcoholic beverages, even if your pancreatitis is mild.

Other treatments may involve:

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

Outlook (Prognosis)

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

Possible Complications

Complications may include:

When to Contact a Medical Professional

Call your health care provider if:

Prevention

Determining the cause of acute pancreatitis and treating it quickly may help prevent chronic pancreatitis. Limiting the amount of alcohol you drink can reduce your risk of getting this condition.

References

  1. Forsmark CE. Pancreatitis. In: Goldman L, Shafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 46.

Review Date: 2/10/2014.

Reviewed by: Todd Eisner, MD, Private practice specializing in Gastroenterology, Boca Raton, FL. Affiliate Assistant Professor, Florida Atlantic University School of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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Copyright © 2013, A.D.A.M., Inc.

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 an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. 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 policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Pancreatic enzymes for chronic pancreatitisPancreatic enzymes for chronic pancreatitis
    Chronic pancreatitis is a condition afflicting nearly 0.04% to 5% of the population worldwide. The disease presents as recurrent episodes of abdominal pain, fatty stools and weight loss, or may be asymptomatic. Patients may develop complications over a variable period of time. Medical treatment often involves prescription of pancreatic enzyme preparations for these patients. This practice is based on studies which have shown the benefit of pancreatic enzymes on various outcomes such as abdominal pain, weight loss, analgesic use, fatty stools and quality of life. However, a collective conclusion about the role of pancreatic enzymes in chronic pancreatitis patients needs to be established from these studies. This systematic review aimed to collect all published and unpublished data on this subject in order to evaluate whether pancreatic enzymes have any benefit on various parameters in chronic pancreatitis, to compare different types of enzyme preparations and to evaluate whether different dosage schedules have any influence on the various outcomes. We included 10 studies in the review. These studies had enrolled small numbers of patients. Though individual studies showed benefit of varying degrees on the parameters mentioned above, we could not pool the results of these studies. With the evidence available so far, no definitive conclusion can be drawn for the benefit of pancreatic enzymes in patients with chronic pancreatitis.
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Figures

  • Digestive system.
    Pancreatitis, chronic - CT scan.

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