What is the difference between acute pancreatitis and chronic pancreatitis?
Acute pancreatitis is an isolated episode of abdominal pain accompanied by elevations
in blood enzyme levels. Essentially, it describes active inflammation of the pancreas.
More than 80 percent of the cases of acute pancreatitis are related to biliary stones or
alcohol use. Acute pancreatitis may lead to chronic pancreatitis.
Chronic pancreatitis is a painful disease of the pancreas in which inflammation has resolved, but with resultant damage to the gland characterized by fibrosis, calcification and ductal inflammation. It is possible for patients with chronic pancreatitis to have episodes of acute pancreatitis.
What causes chronic pancreatitis?
The most common cause of chronic pancreatitis are
- Alcohol consumption.
- Hyperparathyroidism (increased secretion from the parathyroid glands)
- Trauma to the pancreas.
- Tropical pancreatitis, a variant of chronic pancreatitis, is seen in tropical parts of
Asia and Africa, and can affect children between 12 and 15 years of age.
- Recurrent acute pancreatitis..
What are the symptoms of chronic pancreatitis?
Symptoms of chronic pancreatitis range widely
- Acute abdominal pain ranging from severe to mild radiating to back. The pain of chronic pancreatitis often radiates to the back, although it may radiate to both upper and lower quadrants. Sitting up and leaning forward may relieve or reduce discomfort
- Epigastric tenderness
- Weight loss
- Steatorrhea( passing of undigested fat in stools)
- Glucose intolerance/ Diabetes
- Diarrhea which may be chronic (six or more bowel movements per day). The diarrhea is a result of fat malabsorption, which results in bulky, foul-smelling stools that may appear oily and float (steatorrhea).
How is chronic pancreatitis diagnosed?
Chronic pancreatitis is best diagnosed using historical information, serum enzymes,
exocrine function and radiographic studies (X-rays), ultrasound abdomen, CT/MRI scan.
Tests of exocrine function (fat absorption) are helpful.
Are there any particular complications that result from chronic pancreatitis?
Yes. Nutrient malabsorption, diabetes mellitus are main complications of chronic pancreatitis. Patients with chronic pancreatitis are also at increased risk of chronic pancreatitis.
Malabsorption is faulty absorption of nutrients from the digestive tract. In chronic pancreatitis, malabsorption occurs after the capacity for enzyme secretion is reduced by more than 90 percent. Fat absorption suffers to maximum extent in case of chronic pancreatitis.
Chronic pancreatitis affects the endocrine function of the pancreas, responsible for insulin and glucagon production.
Diabetes is common in patients with chronic pancreatitis, and the incidence increases over time with the progression of the disease. Approximately 45 percent of patients with chronic pancreatitis will develop diabetes. Fortunately, the pancreatic form of diabetes is usually mild and the usual complications (retinopathy, nephropathy and vasculopathy) are uncommon. Neuropathic complications may occur with continued alcohol abuse or malnutrition.
How is chronic pancreatitis treated?
Treatment for chronic pancreatitis includes medical, endoscopic and surgical therapy.
Can patients expect long-term relief of pain after surgery?
Surgical intervention provides long-term relief of pain in 90 percent of patients. When
patients have exhausted other avenues of treatment for pain relief, surgery should be
If I have chronic pancreatitis and am being treated, can I expect a full recovery from this disease?
The changes of chronic pancreatitis are not reversible. However, it is possible to have
control of pain and steatorrhea with medical, endoscopic, percutaneous or surgical
treatment. Surgery provides the best relief of pain in short as well as long term. In
addition to pain relief , surgery can slow down destruction of pancreas thus delaying
onset of diabetes mellitus and malabsoption.