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Overview of Chronic Pancreatitis

What’s Chronic Pancreatitis

Pancreas is one the major glands present behind the stomach and strategically situated in front of your spine. It mainly helps produce digestive enzymes as well as hormones aiding the process of digestion. And this major organ helps keep your blood sugar under control.

Chronic Pancreatitis is a kind of irreversible disorder, due to a severe inflammation of your pancreas.

A short term inflammation of the pancreas is Acute Pancreatitis. Chronic pancreatitis is long standing and repeated inflammation of the pancreas. Here the functional capacity of the gland is reduced to very low levels. Calcium stones and fluid filled cysts form within the pancreas and obstruct the delivery of digestive enzymes into the intestine. Pancreatitis prevents your body from digesting food and then regulating your blood sugar. Thus the patient slowly develops features of malnutrition and diabetes.

Causes of Chronic Pancreatitis

There are many causes of chronic pancreatitis, most common causes include

• Long standing alcohol abuse
• Auto immune - which means, your body’s immune system erroneously attacks healthier cells and tissues
• Consumption of tapioca or cassava has been implicated as a cause in South India
• Congenital anomalies of the pancreatic duct.
• Hereditary (familial)
• Cystic fibrosis – a disorder that causes thick secretions in the lungs, and as well as the pancreas

Symptoms of Chronic Pancreatitis

During the initial stages, you may not notice any symptoms. The common symptoms include

• Upper abdomen pain, made worse by eating. This pain may shoot through towards your back (spine) and sometimes you may find relief by stooping forward.
• Fatty or greasy stools, that are pale and don’t flush away easily due to malabsorption
• Diarrhea
• Nausea coupled with vomiting
• Loss of weight
• Fatigue

Some also experience symptoms like

• Yellowish discoloration of eyes and urine

• Abdominal distension due to fluid accumulation within the abdomen

• Vomiting due to intestinal block

Diagnosis of Chronic Pancreatitis

Blood tests

Blood tests are rarely used to diagnose chronic pancreatitis but complications due to pancreatitis may be detected by liver function tests.

Stool tests

Your physician may order fat estimation in your stools, which will indicate the degree of malabsorption. Pancreatic enzyme levels are measured in stools and will detect the severity of pancreatic malfunction.

Imaging tests

These form the mainstay of diagnosis in Chronic pancreatitis and includeX rays - May show calcium stones distributed along the length of the glandCT Scan and MRI scans

Will help your physician identify the extent of disease and provide information regarding associated complications due to the disease like cyst formation and associated cancerous changes

Endoscopic ultrasound

Your doctor inserts a long lighted and flexible tube fitted with a mini ultrasound probe at its tip, through your oral cavity. Pancreatic structural abnormalities can be picked up and suspicious areas can be biopsied.

Treatment Procedures

You should understand that the disease is irreversible and the main intention of treatment is to get rid of your pain and improve digestive function. This involves

Medication

1. Analgesics - pain killers to suppress the pain associated with the inflammation and ductal blockage of your pancreas
2. Pancreatic Enzyme supplements – Artificial digestive enzymes in capsule form to be taken along with your meals to help in digestion.
3. Steroids - in case you are diagnosed with auto immune pancreatitis.
4. Insulin, just in case you have diabetes as well.

Endoscopy

Here, with the help of endoscopy, plastic tubes called stents can be inserted into the pancreatic duct to, improve flow of enzymes, sometimes remove stones causing blockage. They can also be helpful in treating pancreatic fluid leaks within the abdomen.

Surgical procedures

Surgery provides very good relief of symptoms like pain and malabsorption. Most patients who don’t find good improvement with medicines will need surgery at some point of time. Surgery involves opening the pancreatic duct, removing all stones and enabling better drainage of pancreatic enzymes into your intestines. Complications due to chronic pancreatitis may also be addressed by surgery.