Chronic Pancreatitis: Causes and Symptoms

Pancreas and its unique tasks

Among the other organs in and around the stomach, you'll find the pancreas; comparatively small but mighty in its tasks. In our body, the pancreas is found at the back of the stomach, right next to the small intestine.

  • The pancreas works like the personalized health coach to control sugar levels, it creates a particular juice that helps to absorb nutrients from food and keeps the body in good healthy shape.

  • The digestive enzymes like lipase break down fatty substances, protease splits the proteins and amylase divides carbohydrates into energy-rich sugars.

  • The organ is also responsible for the discharging of insulin and glucagon in the body. These hormones are in constant interplay to strike a balance between too little and too much sugar in the blood.

Such a healthy balance may be destroyed in case of pancreatic disease.

The painful Pancreatitis and its types:

The inflammation of the pancreas is called Pancreatitis. When the enzymes released by the pancreas become activated, much before they enter into the small intestine, they start attacking the pancreas itself, resulting in inflammation or pancreatitis.

Acute Pancreatitis

Sometimes the pancreas swells up suddenly and unexpectedly for a short period causing Acute Pancreatitis. It usually lasts for days in case of mild pancreatitis and gets recovered completely, but severe cases can cause life-threatening complications. The most common cause is Gallstones.

This can cause discomfort and bleeding and also form cysts which may become malignant.  

Chronic Pancreatitis

The digestive enzymes travel normally through small tubes inside the pancreas and empty into the intestine. Sometimes due to blockage in the tubes, these enzymes get trapped inside the pancreas causing pain and scarring. These trapped enzymes slowly damage the pancreas. When the swelling of the pancreas lasts for longer periods and the pain and discomfort keeps coming back over months or years, it is referred to as Chronic Pancreatitis.  

A Sneak peek into Chronic pancreatitis

People experience intolerable levels of pain making the disease a real nightmare. Around 70% of people with chronic pancreatitis are found to be alcohol addicts. Chronic pancreatitis can result in scarring and damaging the pancreas permanently. Calcium stones and cysts can develop in pancreas, which ends up blocking the duct that carries digestive enzymes and juices to the intestine. This can lead to serious health concerns like malnutrition and diabetes.

Causes of Chronic Pancreatitis

Chronic pancreatitis is caused by:

The most commonly known cause of chronic pancreatitis is drinking too much alcohol for over several years. Other causes are:

  • Heredity -- Hereditary chronic pancreatitis is a rare genetic disorder that predisposes a person to develop the disease, usually before age 20.

  • Previous multiple attacks of acute pancreatitis leading to damage of pancreatic ducts

A blockage in the main part of the pancreatic duct caused due to cancer abnormalities of the pancreas or of the shape or location of the pancreatic duct

  • Autoimmune disorders - Person's pancreas are attacked by their immune system

  • Cystic fibrosis - a genetic condition in which the pancreas and some other organs get damaged

  • A hereditary disease of the pancreas - Due to certain genetic conditions, a person is born with a faulty pancreas

  • Smoking

  • High calcium (hypercalcemia) and triglyceride fat (hypertriglyceridemia) levels in the blood.

Symptoms to watch out for: 

The biggest menace when it comes to chronic pancreatitis is the excruciating pain associated with it. Pain is felt in the upper belly and travels through the body to the back. During these episodes of severe pain, nausea and vomiting become frequent visitors. As the disease advances, there may be constant abdominal pain.

Because the pancreas is not functioning correctly, food is not broken down properly causing nausea and vomiting. Since the body cannot digest the food that is put in, it results in diarrhoea and oily stools and severe weight loss and malnutrition in the long run. 

The accumulation of pancreatic fluids in the body can cause yellowish discolouration in eyes and skin or jaundice. 

  • Smelly and oily stools
  • Bloat near abdomen

  • Cramps in the abdomen 

  • Flatulence

Due to insufficient or no insulin at all, Thirst and frequent urination

  • Intensified hunger

  • Loss of weight

  • Tiredness and blur in vision

Who is at greater risk:

Alcohol abusers are at a higher risk of chronic pancreatitis disease. Smoking greatly increases the risk among alcoholics. In some cases, a history of the disease in the family can increase the risk. This condition is found to be more common in men compared to women.

Diagnosis of Chronic Pancreatitis

Blood tests and certain imaging techniques are used to diagnose this disease: 

Blood tests are done for checking the glucose, lipase and amylase levels.

Imaging tests are very reliable methods and doctors usually look for abdominal inflammation through:

  • X-ray imaging

  • Ultrasound scans

  • CT scans

  • MRI scans.

Treatment of Chronic Pancreatitis

 The damaged pancreas cannot be repaired, but the symptoms are manageable. Treatment options for chronic pancreatitis involve relieving the pain and improving digestion. These include:

  • Pain medications

  • Artificial digestive enzymes supplements to help in digestion of food

  • Administration of insulin in case of diabetes

  • Steroids are prescribed in autoimmune pancreatitis cases 

  • Endoscopy to reduce pain and free blockages. A long, flexible tube is inserted to remove stones in the pancreas and to place stents (small tubes) to improve the flow

  • Surgery to unblock or widen the pancreatic duct and drain cysts.

 

Dr Lovkesh Anand

Consultant - Gastroenterology

Manipal Hospitals, Dwarka, Delhi

 

 

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