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Chronic pancreatitis

Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic

Pancreatitis is swelling of the pancreas. Chronic pancreatitis is present when this problem does not heal or improve, gets worse over time, and leads to permanent damage.

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Digestive system
Pancreatitis, chronic - CT scan

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Causes

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

When scarring of the pancreas occurs, 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 mellitus.

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 or caused by gall stones.

Other conditions that have been linked to chronic pancreatitis:

Chronic pancreatitis is more common in men than in women. This often occurs in people ages 30 to 40.

Symptoms

Symptoms include:

ABDOMINAL PAIN

DIGESTIVE PROBLEMS

Exams and Tests

Tests to diagnose pancreatitis include:

Tests that may show the cause of pancreatitis include:

Imaging tests that can show swelling, scarring, or other changes of the pancreas may be seen on:

ERCP is a procedure that looks at your bile and pancreatic ducts. It is done through an endoscope.

Treatment

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

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:

The health care provider may prescribe pancreatic enzymes. You must take these medicines with every meal, and even with snacks. The enzymes will help you digest food better, gain weight and reduce diarrhea.

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

Other treatments may involve:

Surgery may be performed if a blockage is found. In severe cases, a 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 provider if:

Prevention

Finding the cause of acute pancreatitis and treating it quickly may help prevent chronic pancreatitis. Limit the amount of alcohol you drink to reduce your risk of developing this condition.

Related Information

Glucagon blood test
Alcohol use disorder
Alcohol use and safe drinking
High blood cholesterol levels
Hyperparathyroidism
Diabetes
Bile duct obstruction
Malabsorption
Ascites
Pancreatitis - discharge

References

Forsmark CE. Chronic pancreatitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 59.

Forsmark CE. Pancreatitis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 144.

Paniccia A, Edil BH. The management of chronic pancreatitis. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 12th ed. Philadelphia, PA: Elsevier; 2017: 532-538.

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Review Date: 9/28/2017  

Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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