Chronic pancreatitis affects the organ known as the pancreas, which is located below your stomach. The pancreas produces enzymes, which help to digest your food, and hormones such as insulin, which regulates the level of sugar in your bloodstream. If you have pancreatitis, this means that something has caused your pancreas to become inflamed. A sudden attack that only lasts for a few days is considered acute, but if the condition lasts over a longer period, (even up to several years) this is described as chronic pancreatitis. Over time, the inflammation can cause scarring and damage. Calcium stones may also develop in your pancreas; these can block the outlet, or pancreatic duct, that carries digestive enzymes and juices into your gut. Levels of pancreatic enzymes and hormones may fall, leading to problems with your digestion and blood sugar regulation. You may develop malnutrition and have excessive amounts of fat in your stools. If you are unable to maintain your blood sugar levels within normal limits, you may develop diabetes.
At first, you may not have any symptoms. Changes in the pancreas can become quite advanced before you begin to feel unwell.
When symptoms occur, they may include:
pain in your upper abdomen
fatty stools, which are loose, pale, and do not flush away easily
nausea and vomiting
loss of weight
symptoms seen in diabetes, such as excessive thirst and fatigue
The pain of chronic pancreatitis is usually just under your ribs and can extend to your back, with episodes lasting for hours or even days. Later in the disease, the pain may become constant.
Complications can occur such as:
fluid-filled swelling developing in your pancreas
fluid accumulating in your abdomen
a blockage in your intestine
cancer of the pancreas
In the early stages, the disease is not always easy to diagnose because changes in the pancreas are not obvious enough to show up in blood tests and imaging scans.
You may have blood tests to measure levels of pancreatic enzymes, as well as to check the function of your kidneys and liver. Your doctor may also check your blood sugar levels to see if you have diabetes.
You may need to supply a stool sample to test for levels of pancreatic enzymes and fat.
Your doctor might request X-rays, ultrasounds, CT (computed tomography) or MRI (magnetic resonance imaging) scans of your abdomen to check images of your pancreas. You may have an investigation using an endoscope. An endoscope is a long, thin instrument with a camera, which is inserted through your mouth and passed down to the area where the pancreatic duct opens into your gut.
It is important to give up alcohol, even if this was not the cause of your illness. You may also need to restrict the amount of fat in your diet and to take vitamins, although your doctor will advise you about this. You should avoid smoking, as this can increase your risk of developing cancer of the pancreas.
Possible medications that your physician may prescribe for chronic pancreatitis include:
artificial enzymes, if your levels are too low to digest food normally
insulin, for those who have diabetes
steroids, for those with autoimmune pancreatitis
Surgery is not necessary for most people. However, if you have severe pain that is not responding to medication, removing part of your pancreas can sometimes provide relief. Surgery may also be used to unblock your pancreatic duct or to widen it if it is too narrow.