Chronic pancreatitis is progressive inflammation of the pancreas that does not improve over months or years, or that improves and returns frequently, which can lead to permanent changes in the shape and functioning of the pancreas, which is an organ responsible for producing enzymes that participate in the digestion of food, as well as insulin to regulate blood sugar levels.
Chronic pancreatitis can be caused mainly by excessive or constant consumption of alcoholic beverages, but it can also arise due to diseases such as cystic fibrosis or lupus, or even after acute pancreatitis, leading to symptoms such as abdominal pain, diarrhea, nausea or weight loss, for example. Understand what acute pancreatitis is and its causes.
The treatment of chronic pancreatitis is carried out by a gastroenterologist who may recommend changes in diet, avoiding fatty foods, in addition to the use of analgesic or anti-inflammatory medications to relieve pain and, in some cases, surgery.
Main symptoms
The main symptoms of chronic pancreatitis are:
- Frequent pain in the upper part of the abdomen that radiates to the back;
- Abdominal pain that worsens after eating;
- Swollen and painful belly;
- Nausea and vomiting;
- Diarrhea;
- Fatty and clear stools;
- Weight loss without apparent cause;
- Excessive thirst;
- Constant tiredness;
- Feeling of shortness of breath.
Chronic pancreatitis can also cause an increase in blood sugar levels, as the pancreas stops producing enough insulin, which can lead to the development of diabetes mellitus or type 1. Know how to identify the symptoms of type 1 diabetes.
Furthermore, it is possible that a person with chronic pancreatitis does not have symptoms for long periods, however, abdominal pain may appear that starts suddenly, which can last for several hours or days, often requiring hospitalization.
How to confirm the diagnosis
The diagnosis of chronic pancreatitis is made by a gastroenterologist through a physical examination, assessment of health history and lifestyle habits, as well as a complete blood count and other blood tests to assess the amount of enzymes in the pancreas and check the function of the kidneys and liver.
In addition, the doctor may order a stool test to test the levels of fat in the stool, as this may be a sign that the body is not absorbing nutrients from the diet well.
Other tests that the doctor may order to confirm the diagnosis of chronic pancreatitis are X-ray, ultrasound, computed tomography or magnetic resonance imaging, which allow checking for signs of inflammation in the pancreas, as well as an endoscopic ultrasound that allows detailed images of the pancreas.
Possible causes
The main causes of acute pancreatitis are:
- Abusive consumption of alcoholic beverages;
- Autoimmune diseases, such as lupus;
- Genetic diseases, such as cystic fibrosis or hereditary pancreatitis;
- Congenital changes in the pancreatic duct;
- Stone in the gallbladder or pancreas;
- High levels of calcium in the blood;
- High triglycerides.
Chronic pancreatitis is more common to develop between 30 and 40 years of age, and smoking can increase the risk of developing this disease in people who consume alcohol excessively.
How the treatment is carried out
Treatment for chronic pancreatitis is carried out by a gastroenterologist with the aim of relieving pain and improving the functioning of the digestive tract, and the use of medication, surgery or changes in diet may be indicated.
The main treatments for chronic pancreatitis recommended by your doctor are:
1. Medicines
The medications that the gastroenterologist may recommend are analgesics or anti-inflammatories, such as paracetamol or tramadol, to reduce inflammation and relieve pain, and in cases of chronic pancreatitis caused by autoimmune diseases, the use of corticosteroids may be indicated.
Furthermore, in cases where complications of chronic pancreatitis arise, such as diabetes, the doctor may also recommend the use of insulin to control blood sugar levels.
Other medications that your doctor may recommend are antidepressants and anticonvulsants such as amitriptyline or pregabalin, to help relieve chronic pain.
2. Pancreatic enzymes
Pancreatic enzymes may be indicated to help improve food absorption, relieving symptoms of diarrhea and fatty stools, in addition to weight loss caused by impaired nutrient absorption due to chronic pancreatitis.
3. Diet changes
The diet for chronic pancreatitis must be followed with the guidance of a doctor or nutritionist, who should recommend a diet low in fat, avoiding fried foods, cakes or snacks, as these foods require enzymes produced by the pancreas to be correctly digested.
Furthermore, it is important to avoid drinking alcoholic beverages, in addition to stopping smoking, to prevent chronic pancreatitis from getting worse.
Watch the video with nutritionist Tatiana Zanin with food tips for pancreatitis:
4. Endoscopic therapy
Endoscopic therapy can be done by a doctor to remove stones or to correct changes in the channels or ducts of the pancreas, with the aim of relieving pain caused by chronic pancreatitis.
If the stone in the ducts is very large, treatment with lithotripsy may also be indicated, which consists of breaking the stones into small pieces so that they are more easily eliminated from the body, relieving the pain.
5. Nerve block
The doctor can perform a nerve block using endoscopy or using ultrasound to guide the exact location of the nerve, and then apply corticosteroids or analgesics to temporarily relieve pain.
6. Surgery
Surgery is indicated in cases where other treatments have not been effective in relieving pain, and can be done to remove part of the pancreas, to remove stones that are obstructing the pancreatic channels or ducts, or even to correct narrowing of the pancreas ducts. .
Possible complications
Pancreatitis can cause complications such as diabetes mellitus, cyst in the pancreas, obstruction of the bile ducts or rupture of the pancreas, for example.
Furthermore, poor absorption of nutrients from food can lead to the development of malnutrition. Find out how malnutrition is treated.
