Chronic Pancreatitis

This refers to a continuous ongoing low-grade inflammation of the pancreas. Because of the continuous inflammation, scar tissue develops within the pancreas. At first this may result in loss of part of the enzyme producing part of the pancreas. After a variable period of time (which could be after some weeks or months but is usually after many years), the insulin-making part of the pancreas may become destroyed.

For reasons that are not understood, many patients with chronic pancreatitis develop calcium deposits in the pancreas tissue and may form calcium stones in the pancreatic tissue & main pancreatic duct or its side branches. Blockage of the ducts by scar tissue (stricture) or stones will stop enzymes being delivered to the gut and impair digestion. The pancreatic duct may enlarge if it is blocked.

patients with chronic pancreatitis are more likely to develop pancreatic cancer, as they become older. The risk is greatest amongst smokers. The risk appears to increase with age and with the duration of symptoms. The risk is lowest in those under 30 years old and highest in those over 70 years of age. The overall risk is increased about twenty times in patients with ordinary chronic pancreatitis compared to the general population.

The overall risk in those with hereditary pancreatitis is about seventy times in patients compared to the general population. It is recommended by the International Association of Pancreatology that all patients with hereditary pancreatitis be under the care of a specialist pancreas center. Patients with hereditary pancreatitis will receive advice at their specialist center on the best form of screening for pancreatic cancer so that it can be detected early. Screening will not normally commence before the age of 40 years as the cancer nearly always occur after that age. These risk factors of smoking and inheritance are ‘independent’ and therefore all patients are recommended not to smoke – at all.

Chronic Pancreatitis Causes

The cause of chronic pancreatitis is usually due to alcohol drinking in seven out of ten individuals. In three out of ten people there are other causes such as narrowing of the pancreatic duct and hereditary causes. In many cases, the cause remains unknown. If alcohol is thought to be the cause, it is essential that all alcohol drinking be stopped.

Chronic Pancreatitis Symptoms & Signs

The main symptoms of chronic pancreatitis are pain, weight loss, poor digestion, and sugar diabetes. There are no specific signs of chronic pancreatitis. Usually patients are emaciated due to malnutrition & have tenderness in the epigastrium. There are many causes for abdominal pain so that it is essential to establish a diagnosis of chronic pancreatitis by investigation.

Chronic Pancreatitis Treatment

Many patients can be treated by medical treatment only, but a few will require surgery.

Surgery is necessary if the pain becomes severe and cannot be properly treated by simple painkillers or if there are complications of chronic pancreatitis. Not all patients with pain and all complications require a surgery. There can be different views regarding treatment amongst specialists treating the patients.

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