Overview
Chronic pancreatitis is a long-term inflammation of the pancreas that results in irreversible damage. The pancreas loses its ability to produce digestive enzymes and hormones, leading to malnutrition and diabetes. The condition often progresses slowly over many years, causing significant morbidity and affecting quality of life. Early diagnosis and comprehensive management are essential to slow disease progression and prevent complications.
Symptoms
Symptoms include severe abdominal pain that may radiate to the back, nausea, vomiting, weight loss, and oily, smelly stools (steatorrhea). Diabetes may develop later as the endocrine function of the pancreas declines. Other symptoms include abdominal bloating, loss of appetite, and malnutrition. Pain is often the most debilitating symptom and can be constant or episodic.
Causes
The most common cause is heavy alcohol use. Other causes include genetic disorders, autoimmune conditions, and gallstones. Sometimes the cause is unknown. Additional factors include duct obstruction, trauma, hypercalcemia, hyperlipidemia, and certain medications. Genetic mutations such as CFTR, SPINK1, and PRSS1 are increasingly recognized as contributors to hereditary pancreatitis.
Treatment
Treatment focuses on pain management, digestive enzyme supplements, dietary changes, and insulin for diabetes. In severe cases, surgery may be needed. Management also includes lifestyle modifications, particularly alcohol cessation and smoking cessation. Endoscopic procedures may be used to relieve duct obstruction or drain pseudocysts. Nutritional support and vitamin supplementation are important for patients with malabsorption.
When to See a Doctor
See a doctor if you have persistent abdominal pain, especially with weight loss, or if you have risk factors. Seek immediate medical attention if you experience severe abdominal pain that is unrelenting, accompanied by fever, jaundice, or inability to eat or drink. Early evaluation by a gastroenterologist can help prevent complications and improve long-term outcomes.