Patient education: Chronic pancreatitis (The Basics)

What is pancreatitis? — Pancreatitis is a condition that can cause severe belly pain.

The pancreas is an organ that makes hormones and juices that help break down food (figure 1). Pancreatitis is the term for when the pancreas gets irritated or swollen.

"Chronic" pancreatitis is when the pancreas gets damaged by irritation over time.

What causes chronic pancreatitis? — Chronic pancreatitis is often caused by:

●Heavy alcohol use

●Smoking

●High triglyceride levels

In other cases, chronic pancreatitis can be:

●Hereditary – This means that it is caused by a gene that runs in families.

●Autoimmune – This is when the immune system attacks the pancreas. The immune system is the body's infection-fighting system.

Sometimes, a person has chronic pancreatitis due to blockage of the pancreatic duct. In other cases, chronic pancreatitis happens with no obvious cause.

What are the symptoms of chronic pancreatitis? — Symptoms include:

●Pain – Pain usually starts in the upper belly. It sometimes spreads to the back. Some people have more pain if they lie down or after a meal. The pain might come with nausea or vomiting.

●Trouble digesting food normally – This can cause bowel movements that look oily or float in the toilet. Some people have diarrhea or lose weight.

Some people do not notice any symptoms. They might find out that they have chronic pancreatitis when they have tests done for another reason.

Over time, chronic pancreatitis can lead to other health problems. These include osteoporosis (weakening of the bones) and diabetes.

People with chronic pancreatitis are at higher risk of getting pancreatic cancer. Scarring of the pancreas can also lead to blockage of the bile duct. This can cause jaundice (yellowing of the skin) or blockage of the small intestine. If the small intestine is blocked, it can cause pain after eating and feeling full after eating only a small amount.

Is there a test for chronic pancreatitis? — Yes. If your doctor thinks that you might have chronic pancreatitis, they will do an imaging test. (Imaging tests create picture of the inside of the body.) Tests include:

●CT scan

●MRI

Sometimes, your doctor will do other tests to figure out what is causing your symptoms. These might include:

●Tests on a sample of fluid from your small intestine

●Other imaging tests, such as ultrasound

●Blood tests

●Tests on a sample of bowel movement

How is chronic pancreatitis treated? — Chronic pancreatitis cannot be cured. But treatment can help slow down the damage to the pancreas. It can also help relieve symptoms.

Treatment usually involves:

●Medicines to help with pain – Doctors usually recommend acetaminophen (sample brand name: Tylenol) or medicines called "NSAIDs" first. NSAIDs include aspirin, ibuprofen (sample brand names: Advil, Motrin), and naproxen (sample brand names: Aleve, Naprosyn). If these do not help, doctors might prescribe stronger pain medicines.

●Other medicines – You might need medicines to control your blood sugar. You might also get "enzymes" to help your body digest food. You will need extra vitamins if your body cannot absorb these from food.

●Avoiding alcohol – If your pancreatitis is related to alcohol use, avoiding alcohol is the most important thing you can to do keep it from getting worse.

●Quitting smoking, if you smoke – If you are having trouble quitting, your doctor or nurse can help.

●Changes to your diet – Some people feel better if they eat small, low-fat meals. Doctors also often recommend drinking plenty of water.

If the above treatments do not help, doctors might recommend:

●A shot of numbing medicine – This blocks a nerve in the belly that sends pain signals to the brain.

●Treatment to widen the pancreatic duct – The pancreatic duct drains juices into the small intestine. These juices help your body digest food. In people with chronic pancreatitis, the duct can become narrowed or blocked. This makes symptoms worse.

●Surgery – This involves removing part or all of the pancreas.

More on this topic

Patient education: Pancreatitis – Discharge instructions (The Basics)
Patient education: Acute pancreatitis (The Basics)
Patient education: Pancreatic cancer (The Basics)
Patient education: High triglycerides (The Basics)
Patient education: Jaundice in adults (The Basics)
Patient education: Low-fat diet (The Basics)

Patient education: Chronic pancreatitis (Beyond the Basics)
Patient education: Acute pancreatitis (Beyond the Basics)
Patient education: Pancreatic cancer (Beyond the Basics)
Patient education: High cholesterol and lipids (Beyond the Basics)