What is chronic pancreatitis?
Chronic pancreatitis is a chronic inflammatory condition that affects the pancreas and is characterised by a constant, dull, central abdominal pain that often goes through to the back. The pain can be quite debilitating and is associated with other symptoms such as poor appetite, weight loss and vomiting.
The main cause of chronic pancreatitis is long term alcohol abuse. Smoking is also associated with chronic pancreatitis lasting longer and causing the pancreas gland to become hard and fibrotic. There are inherited types of chronic pancreatitis, but these are rare. Chronic pancreatitis lasting greater than ten years can be associated with the development of pancreatic cancer and your surgeon will discuss surveillance with you.
Diagnosis
Most patients are diagnosed by a combination of a good history and a computed tomography (CT) scan. Sometimes patients require an Endoscopic Ultrasound (EUS) to diagnose early forms of chronic pancreatitis. This is a type of endoscopy test down the mouth which allows high resolution pictures of the pancreas with ultrasound. Some patients have symptoms of pancreatic exocrine insufficiency (PEI). This means that there are not enough pancreas enzymes to digest your food. Symptoms include bloating, loose bowel motions, urgency to go to the toilet, floating stools that are hard to flush, and sometime weight loss. Your surgeon will go through your symptoms and start you on Pancreatic Enzyme Replacement Therapy (PERT) if necessary.
Treatment
The mainstay of treatment in chronic pancreatitis is to treat the underlying cause of the pancreatitis, either with stopping alcohol consumption or smoking cessation, and treatment of any PEI symptoms. Pain relief is supplied by careful oral analgesia and in some cases, specialised nerve blocks are required. Very rarely surgery is needed to decompress the pancreas or to treat jaundice. Chronic pancreatitis requires specialised care and Manchester Surgical Clinic has specialised pancreatic surgeons to help tailor your treatment.