Chronic pancreatitis

Chronic pancreatitis occurs when your pancreas becomes permanently damaged from inflammation. This is different to acute pancreatitis, where the pancreas becomes inflamed for a short period of time.

Key points

Your pancreas is a small organ located behind your stomach and below your ribcage. It is a part of your digestive system. It secretes enzymes, or digestive juices, into your small intestine to further break down food after it has left your stomach. It also secretes the hormone insulin into your bloodstream to regulate your glucose or sugar levels.

Chronic pancreatitis happens when your pancreas becomes permanently damaged from inflammation. This inflammation is usually caused by heavy drinking, although smoking has also been found to be linked to chronic pancreatitis.The inflammation causes scarring and damage to parts of the pancreas, which affects its ability to produce digestive enzymes and insulin. 1

Some rare genetic conditions, such as cystic fibrosis, or auto-immune conditions, such as  Sjogren's syndrome and a liver disease called primary biliary cirrhosis, can also increase your chance of getting chronic pancreatitis.1

Chronic pancreatitis can affect people of any age, but is most common in men aged between 45 and 54.2

Having chronic pancreatitis increases your risks of getting pancreatic cancer.3

Treatment manages symptoms but it cannot repair damage. This means chronic pancreatitis can affect your life quite a lot, and getting support is important.

What are the causes of chronic pancreatitis?

Long-term alcohol misuse is responsible for around seven out of 10 cases of chronic pancreatitis.2

Less common causes include:

  • smoking
  • a problem with the immune system, causing it to attack the pancreas
  • an inherited genetic mutation disrupting the functions of the pancreas.

In as many as three out of 10 people, the cause cannot be identified.2

What are the symptoms of chronic pancreatitis?

The most common symptom of chronic pancreatitis is repeated episodes of pain, just below your ribs, which may extend into your back. It may be mild at first but can become quite severe. Eating can make the pain worse. However, one in five people have no pain.1

You may also feel nausea (sick), have problems with your digestion (because the pancreas isn’t producing enough enzymes) or develop diabetes (because your pancreas isn’t producing enough insulin. Over time, you may have greasy, foul-smelling stools. 

How is chronic pancreatitis diagnosed?

Because it ca be difficult to diagnose chronic pancreatitis, your doctor may ask you to take a few tests, including blood tests, a stool sample, x-ray, CT scan or MRI.

What is the treatment for chronic pancreatitis?                  

The key treatment is stop drinking alcohol for the rest of your life. You will probably also be prescribed painkillers and other medication if needed to help with your enzyme or insulin levels. You will also be advised to stop smoking and avoid fatty foods.

There is no treatment to repair damage that has already occurred to your pancreas. Surgery is sometimes needed to treat severe chronic pain that doesn't respond to painkillers.

Living with chronic pain can affect your mental health. Talk to your doctor if you are finding it difficult to cope, and they can recommend a counsellor or therapist to help you.

Medication

Depending on the cause of your pancreatitis and your symptoms, you may be prescribed medication to help you feel better.

  • You may be prescribed medication to relieve pain, such as paracetamol and ibuprofen for mild pain, and stronger painkillers such as morphine or tramadol for severe pain.
  • To help improve your digestive system, you may be given pancreatic enzyme supplements, which is medication containing an artificial version of the enzymes produced by your pancreas.
  • If your pancreatitis is caused by problems with your immune system, you may be prescribed corticosteroids to reduce inflammation of the pancreas.

What can I do to care for myself if I have chronic pancreatitis?

The best thing you can do for yourself is to stop drinking. Tell your doctor if you need support to do this. You will also help yourself if you:

  • quit smoking
  • avoid fatty foods
  • eat several small meals per day rather than three large meals
  • take any medicine as prescribed
  • get help if you are finding it difficult to cope.

What support is there for living with chronic pancreatitis?

There are online support groups for people with chronic pancreatitis, such as Facebook support group for chronic and acute pancreatitis,

You can also find a counsellor to talk to about living with this condition.

How can I prevent chronic pancreatitis? 

The best way to prevent chronic pancreatitis is to either avoid alcohol, or if you do drink it, stick to the recommended daily and weekly limits for drinking alcohol. Quitting smoking may also reduce your risk of getting chronic pancreatitis. Eating a healthy diet may also help.4  

Learn more 

Chronic pancreatitis NHS Choices, UK, 2015
Chronic pancreatitis, Patient Info, UK, 2016
Alcohol and problem drinking Health Navigator, New Zealand, 2015

References

  1. Chronic pancreatitis Patient Info, UK, 2016
  2. Chronic pancreatitis NHS Choices, UK, 2015
  3. Cancer of the pancreas NHS Choices, UK, 2016
  4. Alsamarrai A, Das SLM, Windsor JA, Petrov MS. Factors that affect risk for pancreatic disease in the general population: A systematic review and meta-analysis of prospective cohort studies. Clin Gastroenterol Hepatol. 2014 Oct;12(10):1635–164. doi: 10.1016/j.cgh.2014.01.038. www.cghjournal.org/article/S1542-3565(14)00183-9/fulltext