Do you have questions about Chronic Pancreatitis?

A significant part of my practice is helping patients with all kind of problems with their pancreas - one of the major organs for digestion. For this article I want to try and answer some of the more common questions I get about diseases of the pancreas.

First of all - what does the pancreas do?

The pancreas is important for digestion. It secretes a number of digestive enzymes for carbohydrate, fat, and protein digestion. It is also the producer of Insulin - and when the pancreas can't produce insulin it results in diabetes ("insulin-dependent diabetes").

What is Acute Pancreatitis?

Acute Pancreatitis is when the pancreatic tissue gets inflamed. This is typically a painful illness resulting is severe belly pain which can sometimes radiate to the back, nausea, vomiting, and possibly fevers. The most common reason to get acute pancreatitis in the USA is from gallstones or alcohol consumption. The main treatment is actually supportive - IV fluids, pain control, nausea meds, and not eating for a bit. In many cases the pancreas can recover from an attack of acute pancreatitis.

How about Chronic Pancreatitis?

Chronic Pancreatitis is a little different. In chronic pancreatitis, the pancreas is now scarred - it may be atrophic (shriveled), or even calcified. When you have chronic pancreatitis you don't have much tissue left to produce the digestive enzymes and insulin. The main symptoms are diarrhea, bloating, abdominal pain, and weight loss - you may have all of them, some of them, or none of them - so sometimes diagnosis can be tricky. Chronic pancreatitis can come from repeated episodes of acute pancreatitis, but some patients with risk factors such as chronic cigarette smoking or regular alcohol use may develop chronic pancreatitis without ever having an acute pancreatitis attack.

What is Exocrine Pancreatic Insufficiency (EPI)?

Exocrine Pancreatic Insufficiency, or EPI as it is known, is when the pancreas is not producing enough of the digestive enzymes. It results is problems with digestion and absorption, and can lead to diarrhea, bloating, and weight loss. It is now recognized as a more common reason for chronic diarrhea than previously thought.

So if I have EPI that mans I have Chronic Pancreatitis?

Not exactly. Chronic Pancreatitis is definitely a big reason to have EPI, but there are several others. Diseases or anatomy changes that affect the flow of pancreatic juice will lead to EPI. Patients diagnosed with EPI may benefit from further evaluation for Chronic Pancreatitis, but it does not always need to be present.

Can I live without my pancreas?

Actually yes! Since the pancreas is responsible for insulin and digestive enzymes, we can replace those with injectable insulin and supplemental enzymes. This is often what we do to help out patients with chronic pancreatitis who develop EPI and diabetes.

What about Pancreatic Cancer? Does it relate to Pancreatitis?

Trick question. Patients with chronic pancreatitis have a much higher annual risk to develop pancreatic cancer and need to be watched closely. However, many patients develop cancer without ever having chronic pancreatitis.

So how do I avoid Pancreatic Cancer?

Some simple advice is to avoid development of chronic pancreatitis as it is a risk factor. Minimizing alcohol use, avoiding smoking, and treating gallstones if they are symptomatic are a few good recommendations. If you have a family history of pancreatic cancer, you should speak with your doctor to see if you are eligible for a high risk screening program. Lastly if you have any concerning symptoms such as chronic abdominal pain or weight loss, please get checked out.

---

DISCLAIMER: Please note that this blog is intended for Informational Use only and is not intended to replace personal evaluation and treatment by a medical provider. The information provided on this website is not intended as substitute for medical advice or treatment. Please consult your doctor for any information related to your personal care.