Chronic pancreatitis

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What is it about ?

The pancreas is a digestive gland that is located in the upper abdomen, behind the stomach. It has two functions:

  • Produce and secrete hormones in the blood, such as insulin and glucagon to regulate the level of sugar in the blood (blood sugar) (endocrine secretion);
  • Produce and secrete enzymes in the small intestine for the digestion of sugars, fats and proteins (exocrine secretion).

Chronic pancreatitis is persistent inflammation of the pancreas. It usually occurs after several episodes of acute pancreatitis.

The acute form of inflammation of the pancreas (acute pancreatitis) can be cured. On the other hand, in the chronic form, the pancreas suffers irreversible damage.

The causes

9 times out of 10, thealcohol abuse The root cause is that the person typically consumed around 16 ‘standard drinks’ of alcohol per day for 10 to 15 years.

The other causes are as follows:

Chronic pancreatitis is associated with an increased risk of developing pancreatic cancer.

What is its frequency?

Globally, it is estimated that chronic pancreatitis occurs in 17 to 41 in 100,000 people.1 The averages show a gradual increase in the number of cases. On the other hand, alcohol consumption has remained stable in recent years. The increase is probably due to the increase in the number of patients with gallstones, or new diagnostic techniques for chronic pancreatitis.

Approximately 15 in every 100 people with chronic pancreatitis die within 5 years.

How to recognize it?

The pancreas has two important functions:

  • Produce and secrete hormones in the blood, such as insulin and glucagon to regulate the level of sugar in the blood (blood sugar);
  • Produce and secrete enzymes in the small intestine for the digestion of sugars, fats and proteins.

In about 1 in 2 people with chronic pancreatitis, these two functions are disrupted within 8 years.

Symptoms
  • Scar tissue replaces the infected tissue. This prevents pancreatic enzymes from leaking out, and causes strong pain in the upper abdomen. The pain can radiate to the back.
  • You can also have nausea and vomiting.
  • These digestive disorders cause diarrhea with oily stools and weight loss.
  • When the bile cannot escape, the skin and the whites of the eyes begin to turn yellow (jaundice).
  • Of diabetes may develop due to decreased insulin secretion by the pancreas.

How is the diagnosis made?

The general practitioner will have your blood, stools and urine. Then you will pass a ultrasound.

If chronic pancreatitis is suspected, the doctor will refer you to a specialist for further examinations and a treatment proposal.

What can you do ?

  • Stop immediately and permanently the alcohol.
  • Eat a diet low in fat and low in fiber to avoid diarrhea with fatty stools.
  • Eat several small meals a day and drink plenty of water.
  • If you are diabetic, follow your diet and processing to the letter.

What can your doctor do?

  • The treatment Pain killer is an integral part of the treatment.
  • If you have some diarrhea with oily stools, your doctor will also prescribe pancreatic enzymes. These are drugs that replace substances that the pancreas no longer produces, and which are essential for digestion. It is imperative to take these medications with meals.
  • In the event of severe pain or complications, a surgical intervention sometimes is necessary.
    • We then eliminate the gallstones excretory duct by inserting a tube through the mouth into the small intestine and, if necessary, a stent is placed there. A stent is a small tube that helps restore the evacuation of pancreatic enzymes. This intervention is called a CPRE (endoscopic retrograde cholangiopancreatography).
    • It happens that a more invasive intervention is necessary and requires removing the head of the pancreas, or connecting (shunt) the pancreas directly to the small intestine.

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Sources

  • 1 Lévy, P., Domínguez-Muñoz, E., Imrie, C., Löhr, M., & Maisonneuve, P. (2014). Epidemiology of chronic pancreatitis: Burden of the disease and consequences. United European Gastroenterology Journal, 2 (5), 345-354.