Chronic pancreatitis is characterized by persistent and progressive upper abdominal pain and back pain, which is the hallmark of this condition. Unlike acute pancreatitis, the pain is not sudden in nature but is ongoing due to inflammation of the pancreas. Other symptoms include nausea and vomiting. Due to poor appetite and mal-absorption, patients may suffer from malnutrition. With gradual destruction of the pancreas, patients may develop diabetes mellitus. Diabetes is suspected when patients complain of increased thirst, urination, fatigue and excessive weight loss.
To diagnose this condition, your doctor will interview you and perform a physical examination.
- full blood count
- blood glucose
- liver function tests
- Abdominal ultrasound
- CT scan
- Endoscopic Retrograde CholangioPancreatography (ERCP)
- Endoscopic ultrasound (EUS)
- Magnetic resonance imaging (MRI) or magnetic resonance cholangiopancreatography (MRCP)
Your doctor will explain to you why one imaging modality is preferred over the other. In some cases, a combination of imaging modalities is necessary for evaluation of the disease.
You may be referred to an endocrinologist for a glucose tolerance test to confirm the diagnosis of diabetes mellitus.
The most common cause of chronic pancreatitis is excessive alcohol drinking. Over time, the alcohol damages the pancreas and destroys its functions in producing digestive enzymes and hormones.
Other causes include consumption of traditional medication over a prolonged period.
The main focus in the treatment for chronic pancreatitis is pain control and nutritional support. A low fat diet supplemented by with pancreatic enzyme capsules is advised. Absolute abstinence from alcohol is strongly encouraged.
In some patients, surgery may be necessary to control the persistent abdominal pain by removing the damaged pancreas or duct or to restore the drainage of the duct into the intestine.
Long term follow-up is advised because chronic pancreatitis is a risk factor for pancreas cancer over a period of time.