Chronic Pancreatitis: Causes, Symptoms, Treatments

Pancreas, is a large gland present near the stomach. There are two important functions performed by pancreas in the digestive system. The first is to secrete important hormones like insulin and glucogen; while the second, is to produce digestive juices that help to break down fats, proteins and carbohydrates in the small intestine. Inflammation of pancreas due to chronic pancreatitis, reduces the production of the digestive juices and also the amount of hormones secreted by the pancreas. There are two types of pancreatitis, acute pancreatitis and chronic pancreatitis. Here we shall look into its causes, symptoms and treatment.

Causes

Alcohol consumption is the primary cause of chronic pancreatitis, contributing 70% of the total cases. A prolonged period (i.e. 10 years or more) of alcoholism increases the risk of chronic pancreatitis. There are many other causes, and some of them are listed below.

• Cystic fibrosis
• Genetic disorder, namely mutation of the 'gene 7'. This faulty gene can be inherited from parents. Pancreatitis that is caused due to the inheritance of a mutated gene, is called hereditary pancreatitis.
• Cancer / Gallstones resulting in the narrowing of the pancreatic duct.
• Anatomical problem, like a person born with structural problems of the pancreas.
• Hyperparathyroidism or over-secretion of hormones by the parathyroid gland leading to elevation in calcium levels.
• Injury or trauma to the pancreatic area causing inflammation.

Symptoms

Abdominal pain is the chief symptom of chronic pancreatitis. The patient suffers from severe pain in the upper part of abdomen. This pain may be continuous, may increase after eating or drinking anything, and may last from a few hours to 1-4 days. The list of other symptoms observed is given below.

• Vomiting
• Weakness
• Jaundice
• Diabetes
• Fatty stools
• Nausea
• Digestion Problem

Diagnosis

Chronic pancreatitis is seen more commonly in men between age 30-40. On observation of any of the symptoms, the physician will suggest a gastroenterologist (specialist of digestive system disorders), for its diagnosis. The blood and feces samples are taken and sent to laboratory for tests. These tests, however, are not enough to confirm the diagnosis of chronic pancreatitis and more tests are required. Most of these tests are imaging tests that give an image of the pancreas and help to determine if there is any inflammation of the pancreas. These tests that confirm the diagnosis are given below:

Magnetic Resonance Imaging (MRI): It takes multiple X-rays and provides a detailed cross sectional image of the abdominal area around the pancreas.

Ultrasonography: An image of the pancreas is created on the monitor by passing sound waves through the patient's body. This image is called sonogram.

ERCP (Endoscopic retrograde cholangiopancreatography): X-rays of the pancreatic ducts are taken by inserting an endoscope (flexible tube with camera at the inserted end) through patients body.

EUS (Endoscopic Ultrasound): It is a test that combines the techniques used in ultrasound and ERCP. The sound waves are directed towards pancreas from the endoscope.

Biopsy: Sample of the pancreatic tissue is taken and sent to laboratory for further testing.

Treatment

The treatment focuses on reducing the abdominal pain and solving the digestive problems. A diet plan that includes low fat, and high calories and proteins, is usually suggested. People who drink alcohol excessively, should completely stop drinking to avoid dire consequences. To reduce the pain of the abdomen, medications like tramadol are recommended. There may have some side effects of this, so any medication should be taken only after consultation with the doctor. Pancreatic supplements are also given to increase the level of enzymes or the digestive juices that are not secreted by pancreas. Even these medications may have side effects and proper prescription of a physician is recommended. Anatomical problem of the pancreatic duct that leads to sever abdominal pain may need a surgery. Treatment for chronic pancreatitis due to gallstones may involve removal of the gallbladder. Patients who develop diabetes due to chronic pancreatitis, need to maintain the insulin level with medications or by injecting insulin.

In United States every year 87,000 cases of chronic pancreatitis are found. It is not a curable disease, but the symptoms can be reduced. The disease may reduce the life expectancy of the patient. So, timely treatment is essential and one should stop drinking alcohol, if alcoholism was the cause of the disease. Not only chronic pancreatitis, but many other diseases can be prevented by eating healthy food and by avoiding alcohol consumption.