Dr. M.J. Bazos, MD. Patient Handout

PANCREATITIS, CHRONIC

About Your Diagnosis
Chronic pancreatitis is a persistent inflammation of the pancreas. The pancreas is a gland located behind the stomach. It secretes digestive enzymes and the hormones insulin and glucagon. The persistent inflammation leads to the destruction of the functioning glandular tissue in the pancreas. The pancreatic digestive enzymes are not produced, resulting in an inability to properly digest and absorb fat in the diet. There is also a decrease in the production of insulin. Alcohol abuse is the most common cause of this condition. Hemochromatosis (a condition of excess iron in the blood) and cystic fibrosis are other know causes. The incidence of chronic pancreatitis is 2 cases per 10,000 individuals. Men are affected more often than women. Chronic pancreatitis is detected by reviewing the individual’s history. Samples of blood are taken to look for the changes associated with this disease.

Living With Your Diagnosis
The most common symptom of chronic pancreatitis is pain. The pain is variable in its intensity. It may be a low-grade, persistent pain with recurring acute attacks. The pain may be constant and boring. The back and abdomen are the sites of pain. Weight loss is another symptom. This is due to the malabsorption of fat. Steatorrhea (large, foul bulky stools) will occur also because of the fat malabsorption in the gastrointestinal tract. There can be abdominal distention and fever also.

Treatment
There are two focuses of treatment. The first is the management of pain. The preferred treatment for the pain is nonnarcotic pain relievers. Long-term narcotic use can lead to dependence and addiction. Referral to a pain specialist may be helpful. The second focus is replacing the digestive enzymes and insulin that are normally made by the pancreas. Pancreatic enzymes are available in tablet form. These are taken with meals and snacks. Insulin injections are used to control the blood sugar level. It may be necessary to give vitamin supplements because of the malabsorption. Specifically, vitamins A, D, and K are replaced. If the pain cannot be controlled, surgery is an option. The surgery involves draining the pancreatic
duct. In advanced cases, removal of all or part of the pancreas is an option.

The DOs
• Eat a low-fat, well-balanced diet.
• Supplement with oral fat-soluble vitamins.
• Calcium supplementation is indicated to prevent bone problems.
• Take pancreatic enzyme supplements as prescribed.
• See a pain specialist if pain control is difficult.

The DON’Ts
• Avoid fatty foods.
• Avoid alcohol.
• Avoid caffeine.
• Avoid prolonged use of narcotics for pain control.

When to Call Your Doctor
• If symptoms of pancreatitis develop.
• If symptoms of pancreatitis worsen or do not improve with treatment.
• If pain is not controlled with the prescribed pain relievers.
• If fever develops.

Websites:
National Digestive Diseases Information Clearinghouse
www.niddk.nih.gov
nddic@aerie.com