Pancreatitis">Chronic Pancreatitis
What is Chronic Pancreatitis?
Chronic pancreatitis is a continuing inflammation of the
Pancreas. This persisting inflammation can lead to chronic abdominal pain. This disease has an estimate of 87,000 cases a year in the United States. And an increasing number of chronic pancreatitis has been noted from 1945-1985. About 8 out of 100,000 develop this condition in a year in the United Kingdom. The male population is most affected with this condition compared to women. Usually it peaks at the age of 45-50 years. This may be linked to the prevalence rate of alcohol male users.
The pancreas is an essential organ of the body that lies behind the stomach and the intestine. This organ facilitates in the proper food digestion by making a fluid that contains enzymes needed in the process. The pancreas has special cells that are called the ‘Islets of Langerhans’. These cells are responsible for the secretion of vital hormones that regulate our blood sugar such as the insulin and glucagon.
Chronic Pancreatitis Symptoms
The presenting symptom of this disease is abdominal pain. It is characterized as severe, felt mostly in the mid or upper left abdomen that radiates in a band-like manner. The pain can also radiate to the mid back of the body. Patients would complain that the pain occurs after meals or when the stomach is empty, lasting for several hours. Alcohol ingestion has been noted to cause worsening of the pain. There are instances wherein the patient is asymptomatic (without presenting symptoms) for years before they can establish a diagnosis. Variability of the pain pattern among patients may hinder the diagnosis of the condition. Most of the affected will experience pain at unpredictable intervals while others experience
Chronic Pain. There is even painless chronic pancreatitis in a small percentage of the patients.
The patient may develop poor digestion. This is because of insufficient production of enzymes that are activated for digestion. The digestion of fats and vitamins are hindered. As a result, the patient’s feces will contain undigested fats (
Steatorrhea). The patient’s stools would have a distinct smell. Pale or clay-colored stool is an effect of the presence of fats. It is highly expected that their stools will also be oily. Another digestive problem is the chronic loss of weight. This even occurs to patients who have the same eating habits as before.
Since the patient has inadequate functioning, blood sugar regulation is not attained. This would lead to diabetes. It is accounted to patient’s with chronic pancreatitis who can acquire diabetes in a 1 is to 3 ratio. As the patients develop diabetes mellitus, they’ll experience the presenting symptoms of DM such as excessive thirst, frequent urination and increased hunger. This triad of symptoms is the most common manifestations of diabetes. But take note, this condition is a rare turn about chronic pancreatitis.
The patient would also feel very unwell. He/she would complain of nausea at most times.
Diarrhea and vomiting is also experienced by the patient.
Complications may arise if the patient is not treated accordingly. Formation of a pseudocyst is possible in cases where the pancreatic fluid collects into a cyst. This can add to the pain that the patient experiences. This complication would imply a surgical intervention is needed.
Ascites may occur; this is a collection of body fluid in the abdominal cavity.
Jaundice occurs if a complication of blockage in the bile duct takes place. An increased risk to cancer of the pancreas may develop. These are very rare complications. This may only occur if chronic pancreatitis is left untreated and monitored.
Chronic Pancreatitis Causes
The common causes of this case in urban areas are chronic
Alcoholism, presence of gallstones and idiopathic in source (unknown cause). To start, an inflammation usually develops by scarring. Damage to the pancreas is big factor for this condition. Over the years, alcohol ingestion has been pointed out for this condition. But genetics play a significant factor in some cases.
As excessive alcohol consumption is noted the most common cause of this disorder, explaining its mechanism is a way to start. The commonly affected age group is the middle age men. This is because of their overly exposure to alcohol. Heavy drinkers are quite prone to this condition; about 7 out of 10 cases are reported to be alcoholics who obtained the disease.
The role of the genes has been noted to cause this condition. There are cases where the condition is attained because of an underlying genetic disorder,
Cystic Fibrosis. This autosomal recessive disorder is accounted to cause a small percent of the chronic pancreatitis population.
An autoimmune disorder can lead to this condition. Once the immune system overreacts and fight one’s own organs, the possibility to cause scarring/damage to pancreas can happen.
A condition where there are abnormal elevated levels of the lipid in the blood can cause pancreatitis. This condition is called hyperlipidemia.
Increased amounts of calcium in the blood are a rare cause of chronic pancreatitis. This condition may have originated from hyperparathyroidism. The parathyroid glands are responsible in the control of calcium in the blood.
Blunt trauma to the stomach or abdomen can be a root of this condition. The disease may not overtly show after the obstructive incident, but there are reported cases of this. An incident of a whiplash against the spine can complicate to pancreas damage. There are also rare cases of congenital anomalies that can predispose to this disease. Conditions such as pancreas divisum and annular pancreas divisum may cause chronic pancreatitis.
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Chronic Pancreatitis Treatment
Once a person is diagnosed with chronic pancreatitis, he/she should have a lifestyle modification.
It is highly advised to patients to stop alcohol drinking for the rest of his/her life. If ever the cause of pancreatitis is not alcoholism, one should avoid this habit for this can contribute to complications and other diseases. Tobacco or cigarette smoking should be ceased. This can only precipitate to blood vessel constriction, thus worsening the patient’s condition.
Patient’s pain should be controlled. Providing the client pain killers is essential. Alleviating the pain that the patient is experiencing can even increase the patient’s willingness to be treated with the condition. But there are cases that pain killers are not advisable because of its possible effect on worsening the condition, a drug of choice is given. Morphine is provided to patients with intractable pain.
Enzyme replacement therapy has been done and is often effective in treating patients. This can regulate the absorption/digestion of the body. This has been found to relieve steatorrhea and
Malabsorption.
In order to control the blood sugar of the client, he/she is given with insulin. This can be a long-term treatment, as long as the underlying condition is treated.
Surgical interventions are performed in order to relieve the patient’s manifestations. The surgical technique would include the removal of different parts of the pancreas. This procedure is done to patients who are in severe cases, especially if there is inclusion of pancreatic duct blockage and other essential organs. The removal of large calcium stones can be done surgically. If complications occurs such as blockage of the bile duct or a pseudocyst develops it will incline the doctor to do the procedure.
Chronic Pancreatitis Diet
In treating chronic pancreatitis, a strict food regimen should be followed. There are certain foods that are not allowed and there are foods that should be taken for its benefits. These are the following foods to be prepared and ingested by patients with chronic pancreatitis:
- Yogurt –full of probiotics essential in keeping a balanced digestive system
- Vegetable soup – vegetables that are rich in antioxidants are recommended
- Red wine – has an important component resveratrol, an antioxidant. Red wine has been noted for its beneficial effects to our body
- Tofu – a good substitute for meat
Patients should also reduce fat intake that can worsen the symptoms of pancreatitis. Regulate sugar intake, so not to worsen diabetes or to avoid the emergence of diabetes. Having a sufficient vitamin B12 in the diet is essential. This can assist in the digestion. Those with pancreatic insufficiency will have improvement as there is to sufficient vitamin B12 in the body.
Chronic Pancreatitis Prognosis
The prognosis of the client entirely depends on him/her. Willingness to change his habits and outlook in life is a great factor for acquiring a good prognosis. If the patient is a known alcoholic and still continues this bad habit while in treatment, then his prognosis shall be undesirable. An excellent prognosis is at hand when the patient is committed in the treatment course given by the doctor. An early diagnosis of this condition is a related factor for a good outcome of this disease. An early diagnosis can mean an early treatment, leaving out a good result.
Instances where the patient is not willing to recover from the disease, then complications may arise and sever the condition. Other complications such as infection of the pancreas can worsen the chronic pancreatitis. Shock can give out a very undesirable prognosis, because there is involvement of the neighboring organs already.
Having a support system is essential in the treatment of the patient. This can help out in achieving a good prognosis.
Chronic Pancreatitis Life expectancy
Patients who are not very willing to be treated from chronic pancreatitis can have a lower life expectancy rate of 10-20 years. This is common to patients who were diagnosed late and have not received the prompt treatment for this disease.
But it was noted in a study that death caused by pancreatitis only occurred to 3.6% of the patients. There were no cases that included complications such as extra pancreatic cancers. But with the early medical intervention, risk of death is lessened.
