Chronic Pancreatitis

Overview

Chronic pancreatitis is the irreversible damage to the pancreas that is associated with recurrent inflammation, fibrosis and injury to the endocrine and exocrine tissues. It can present as episodes of acute pancreatitis or as chronic damage with persistent pain.

Signs and Symptoms

Upper abdominal pain which is worse after eating and better when leaning forward or fasting, Loss of appetite, Weight loss even when the amount of food eaten is the same, Nausea and vomiting, Steatorrhea, Increased hunger or thirst, Fatigue, Frequent urination

Common Causes

Alcohol, Smoking, High fat and protein diet, Family history of pancreatic disorders, Obstruction due to medical conditions such as benign pancreatic duct obstruction, traumatic stricture, stricture after severe acute pancreatitis, sphincter of oddi dysfunction or stenosis, duodenal wall cyst, pancreas divisum, malignant pancreatic duct stricture, ampullary or duodenal carcinoma, pancreatic adenocarcinoma, intraductal papillary mucinous neoplasm, cystic fibrosis, Gall Stones

Risk Factors

Alcohol, Smoking, High fat and protein diet, Family history of pancreatic disorders, Gall Stones

Investigation Techniques

Full blood count, Serum amylase level, Serum lipase level, Liver function test, Renal function test, Serum calcium, Serum trypsinogen, Blood glucose test, Urine amylase, Transabdominal ultrasound, Chest and abdominal x-ray, Secretin stimulation test, Fecal elastase level

Treatment and Prevention

Lifestyle changes such as stop smoking, avoid alcohol, low fat diet, Pain management involving analgesics, referral to pain management specialist, computerised tomography or endoscopic ultrasound-guided coeliac axis block, Treat underlying medical conditions , Pancreatic enzyme replacement with meals, Surgery involving resectional or drainage procedures