Pancreatitis - Chronic

The pancreas is positioned behind the stomach. It produces enzymes to digest food. When these enzymes attack the pancreas instead, inflammation occurs.

Acute pancreatitis is sudden, severe inflammation. Chronic pancreatitis is ongoing. It may be milder. However, it causes stomach pain, food intolerance and nausea.

Over time, this disease harms the pancreas, making it hard to produce digestive enzymes and hormones. That can lead to chronic diarrhea, malnutrition and diabetes.


Causes and Risk Factors

Most chronic pancreatitis is caused by alcohol abuse. Gallstones, surgical scarring, tumors or an abnormality in the pancreatic duct cause the rest. Rare cases develop from a genetic disorder or cystic fibrosis.


The clearest sign is pain. It can be severe at times. It often seems to go away over time. A doctor will check for signs of jaundice, weakness, severe weight loss and diarrhea or foul-smelling stools.

You should be tested for chronic pancreatitis if you have a family history of pancreatitis, a history of alcohol abuse or several bouts of severe abdominal pain. The doctor will use one or more of the following:

  • Blood tests to check the levels pancreatic enzymes, which tend to be high during an attack.
  • Computed tomography (CT or CAT) scans or ultrasound, both of which can show inflammation and any scarring in soft tissues.
  • Endoscopic retrograde cholangiopancreatography (ERCP), a non-invasive procedure used to find and treat blockages in the pancreatic and biliary ducts.


Though there is no cure, some patients can reduce the symptoms and make up for nutritional deficiencies. Doctors often prescribe digestive enzymes and vitamin supplements. Patients who develop diabetes may have to take insulin shots and follow strict diets.

How severe symptoms are varies. In mild cases caused by alcohol abuse, the patient may be able to get relief by simply avoiding alcohol. Those who don't or fail to respond well to other treatments, often live with disabling daily pain and regular trips to the hospital.

Most pain can be relieved with over-the-counter medications, such as ibuprofen and acetaminophen. Some patients may need narcotics. In a few cases, where there are blockages, surgery or ERCP may open the blocked ducts or remove part of the pancreas.


Screening and Prevention

There is no way to screen for the disease. However, anyone who has had an acute alcohol-induced attack can reduce the risk by stopping or cutting down on the amount of alcohol he or she drinks.