Chronic pancreatitis

Apr 14, 2012 , Jiří Dyntr

2-chronicky-zanet-slinivky.jpg - kopie
2-chronicky-zanet-slinivky.jpg - kopie
Chronic pancreatitis is characterized by a very strong and unpleasant pain in the upper abdomen. Chronic pancreatitis can develop further complications such as jaundice, diabetes type II., in exceptional cases even pancreatic cancer. Complete treatment of chronic pancreatitis is not currently possible; however, patients can improve their quality of life by proper diet and collaboration with physicians.

Chronic pancreatitis

Chronic inflammation of the pancreas or chronic pancreatitis is a condition resulting from long-term pathological processes that lead to damage of the pancreas and thus cause its malfunction. The main cause of chronic pancreatitis is alcohol. In the UK, according to statistics, every year there is just one new case per 11,000 inhabitants. Chronic pancreatitis can be treated conservatively, surgically or endoscopically.

Function of pancreas

The pancreas is one of the major organs involved in the processing of food in the body. The pancreas is divided into two parts, exocrine and endocrine, each with different functions. The exocrine part of the pancreas produces digestive juices that are secreted through the pancreatic duct into the small intestine, where it breaks down various components of food, thus helping their absorption into the blood. The endocrine part of the pancreas is a source of hormones, insulin and glucagon, which are important for maintaining stable levels of blood sugar.

Causes of chronic pancreatitis

As mentioned above, the main cause of chronic pancreatitis is alcohol. It is indicated that the amount of alcohol administered daily for a period of five years, which leads to chronic pancreatitis, is 75 grams for males and 40 g for females. For some people, these numbers may be even lower. Undoubtedly genetic predispositions have an impact on the emergence of this disease, mutations of the CFTR gene. Also autoimmune-induced chronic pancreatitis is discussed, where the components of the immune system attack its own body. Other causes are conditions after acute pancreatitis, certain infections, metabolic disorders, or chronic obstructive pancreatitis.

Symptoms of chronic pancreatitis

The main symptom of chronic pancreatitis is a very strong and unpleasant pain in the upper abdomen. The pain often radiates to the back and can occur either permanently or comes suddenly, in episodes. They are sometimes difficult to distinguish from acute pancreatitis. Other symptoms include bloating, diarrhea, nausea and usually a feeling of fullness and pressure in the upper abdomen. The source of all problems in chronic pancreatitis is the replacement of functional pancreatic tissue with a damaged one. The tissue is a connective tissue formed by cells and fibers that form tendons and ligaments in the body, and in addition fill the spaces between organs. This change causes a very serious lack of both digestive juices and insulin and glucagon, with all its consequences.

Consequences of chronic pancreatitis

Lack of insulin-producing cells may develop diabetes type II. that leads to high blood sugar levels and a variety of other complications such as neuropathy, impaired wound healing and increased incidence of varicose ulcers. Due to insufficient production of digestive juices the digestion and absorption of nutrients in the intestine can be impaired. The body begins to suffer from a lack of building materials and energy, and the patient starts to lose weight. Another cause of weight loss is that patients by themselves reduce the intake of food due to pain during digestion. In some cases, the forming tissue can oppress the bile ducts and lead to jaundice. Chronic pancreatitis can also lead to pancreatic cancer.

Complications of chronic pancreatitis

Chronic pancreatitis can lead to the development of a number of complications that can endanger the patient's life. Complications of chronic pancreatitis include cysts, pseudocysts, rupture of the main pancreatic duct or fistula formation. Also jaundice can develop because of biliary obstruction, duodenal obstruction, or abscess and fistula formation in the spleen. The worst and most serious complication is a malignant tumor, pancreatic carcinoma, which is very difficult to distinguish from chronic pancreatitis.

Diagnosis of chronic pancreatitis

To distinguish acute pancreatitis from painful attacks of chronic pancreatitis is often very difficult. At the present time, to establish the source of pain different methods are used like ultrasound, X-ray, endoscopic methods such as ERCP and various chemical substances are analyzed in the blood and feces. ERCP, or endoscopic retrograde cholangiopancreatography, is a method in which a probe is introduced through the mouth into the duodenum, to the pancreatic duct. The probe is then inserted into the common bile duct and the image is transmitted to a monitor. Thus we can evaluate changes in the pancreatic duct.

Treatment of chronic pancreatitis

Chronic pancreatitis is a disease that must be treated because it can lead to a malignant tumor of the pancreas. Treatment of chronic pancreatitis may be conservative, pharmacological or surgical.

The primary measure in the treatment of chronic inflammation of the pancreas is to regulate eating habits, especially the complete withdrawal of alcoholic beverages and minimizing fats. Animal fats should be replaced with vegetable fats, which are much easier to digest, but should also be consumed in a limited amount.

If due to damage of the pancreas diabetes type II. occurs, it is also necessary to limit the intake of carbohydrates and, if necessary, to stabilize the blood sugar levels by medication. Lack of digestive enzymes that cause defects in the processing of food in the small intestine is supplemented with special pills called pancreatin, which contain all the important components of pancreatic digestive juices. For the severe pain accompanying this disease are often necessary painkillers. An alternative solution is the surgical removal of the pain nerve plexus around the damaged tissue, which can no longer detect pain and the patient feels noticeable relief.

Endoscopic treatment of chronic pancreatitis is pancreatic duct drainage in areas of its narrowing with the possible removal of obstacles. In the presence of cysts it is possible by this method also to evacuate.

Surgical treatment of chronic pancreatitis is drainage, or surgical removal of the damaged part of the organ.

Prognosis of chronic pancreatitis

Chronic pancreatitis is one of the diseases that are in the current state of knowledge and the development of medical science treatable, but not curable. The patient can be provided with fairly decent living conditions, but the basic premise is his own will and conscientious collaboration with physicians. Otherwise, it may cause serious complications that often lead to death.

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