Przewlekłe zapalenie trzustki

Przewlekłe zapalenie trzustki
Objawy

Przewlekłe zapalenie trzustki (PZT) to postępująca choroba charakteryzująca się nieodwracalnym uszkodzeniem trzustki na skutek przewlekłego stanu zapalnego, prowadzącym do włóknienia i utraty funkcji zewnątrzwydzielniczej oraz wewnątrzwydzielniczej. Dominującym objawem jest ból w nadbrzuszu, występujący u około 90% pacjentów, o zmiennym charakterze i nasileniu, z trzema głównymi profilami bólowymi (typ A, B, C). Nasilenie bólu często wzrasta po posiłkach, zwłaszcza wysokotłuszczowych, i łagodzi się podczas głodzenia lub przy pochylonej pozycji. Niewydolność zewnątrzwydzielnicza ujawnia się po utracie około 90% funkcji trzustki, manifestując się biegunką tłuszczową, niedożywieniem i utratą masy ciała. Cukrzyca typu 3c rozwija się u 25-80% pacjentów w ciągu 10-20 lat, objawiając się klasycznymi symptomami hiperglikemii. Progresja choroby jest zmienna i zależy od czynników takich jak kontynuacja spożywania alkoholu, palenie tytoniu, wiek w momencie diagnozy oraz częstość ostrych epizodów zapalenia trzustki.

Objawy przewlekłego zapalenia trzustki

Przewlekłe zapalenie trzustki (PZT) to długotrwała, postępująca choroba, charakteryzująca się nieodwracalnym uszkodzeniem trzustki w wyniku przewlekłego stanu zapalnego. W przeciwieństwie do ostrego zapalenia trzustki, PZT nie ustępuje, lecz pogarsza się z czasem, prowadząc do trwałego uszkodzenia narządu¹². Ciągły stan zapalny powoduje włóknienie tkanek trzustki, co hamuje produkcję enzymów trawiennych i hormonów¹.

Ból jako główny objaw

Najczęstszym objawem PZT jest ból w nadbrzuszu, który często promieniuje do pleców³⁴. Ból może mieć różny charakter i intensywność. Jest opisywany jako palący lub strzelający, może pojawiać się i ustępować, ale czasem utrzymuje się przez kilka godzin lub dni³. U większości pacjentów (około 90%) z PZT występuje ból, choć u około 10% choroba może przebiegać bezboleśnie, szczególnie u osób z idiopatyczną i genetyczną etiologią choroby⁵.

W przebiegu choroby można wyróżnić trzy zasadnicze profile bólowe⁶:

Typ A: przerywane, ciężkie zaostrzenia bólu z okresami bezbólowymi lub bez nich; występuje zwykle we wczesnym stadium choroby
Typ B: przewlekły ból z okresowymi ciężkimi atakami
Typ C: przewlekły, długotrwały, silny ból bez zaostrzeń

⁶

Z czasem, gdy choroba postępuje, epizody bólu mogą stawać się częstsze i bardziej nasilone³². Ostatecznie może rozwinąć się stały, tępy ból w jamie brzusznej, występujący między epizodami silnego bólu². Ten stały ból jest szczególnie częsty u osób, które kontynuują spożywanie alkoholu po zdiagnozowaniu PZT³.

Charakterystyczne cechy bólu w PZT obejmują⁷⁸:

Nasilenie po posiłkach, szczególnie po spożyciu pokarmów wysokotłuszczowych
Zmniejszenie podczas głodzenia
Złagodzenie w pozycji siedzącej lub przy pochyleniu do przodu
Często współwystępuje z nudnościami i wymiotami

⁷⁸

Niewydolność zewnątrzwydzielnicza trzustki

Wraz z postępem choroby, trzustka traci zdolność do produkcji enzymów trawiennych, co prowadzi do objawów niewydolności zewnątrzwydzielniczej⁹. Objawy te zazwyczaj pojawiają się dopiero po utracie około 90% funkcji trzustki, co zwykle następuje kilka lat po wystąpieniu pierwszych objawów⁷¹⁰.

Główne objawy niewydolności zewnątrzwydzielniczej trzustki obejmują¹¹¹²:

Biegunka tłuszczowa (stolce tłuszczowe) – stolce są charakterystycznie tłuste, cuchnące, trudne do spłukania, pozostawiające tłusty film w toalecie
Niedożywienie i utrata masy ciała – nawet przy zachowanym apetycie i normalnych nawykach żywieniowych
Wzdęcia i dyskomfort po jedzeniu
Bóle brzucha po posiłkach

¹¹¹²

Z czasem u 80-85% pacjentów z przewlekłym zapaleniem trzustki rozwinie się niewydolność zewnątrzwydzielnicza¹²¹³. Jest to spowodowane zmniejszoną produkcją enzymów trawiennych, co utrudnia trawienie tłuszczów i niektórych białek¹⁴.

Niewydolność wewnątrzwydzielnicza i cukrzyca

Przewlekłe zapalenie trzustki wpływa również na funkcję wewnątrzwydzielniczą trzustki, prowadząc do zmniejszonej produkcji hormonów regulujących poziom glukozy we krwi, takich jak insulina i glukagon⁹. Z czasem może to prowadzić do rozwoju cukrzycy typu 3c (pankreatogennej)¹⁵.

Objawy związane z cukrzycą w przebiegu PZT obejmują²¹⁶:

Zwiększone pragnienie
Częste oddawanie moczu
Zwiększony apetyt
Niezamierzona utrata masy ciała
Zmęczenie
Niewyraźne widzenie

²¹⁶

Cukrzyca rozwija się u 25-80% pacjentów z PZT w ciągu 10-20 lat od rozpoznania choroby¹². Według innych źródeł, cukrzyca występuje u około 45% osób z przewlekłym zapaleniem trzustki¹⁷¹⁸.

Inne objawy

Oprócz głównych objawów związanych z bólem, niewydolnością zewnątrz- i wewnątrzwydzielniczą trzustki, pacjenci z PZT mogą doświadczać¹⁹²⁰:

Nudności i wymioty – często towarzyszące bólowi
Utrata apetytu
Żółtaczka (zażółcenie skóry i białkówek oczu) – zwłaszcza w przypadku blokady dróg żółciowych
Zmęczenie i ogólne osłabienie
Nieprawidłowości w badaniach laboratoryjnych – szczególnie dotyczące parametrów trzustkowych

¹⁹²⁰

Warto zauważyć, że niektórzy pacjenci z PZT mogą nie mieć objawów aż do momentu wystąpienia powikłań²¹²².

Progresja przewlekłego zapalenia trzustki

Przewlekłe zapalenie trzustki to choroba postępująca, która rozwija się przez wiele lat. Tempo progresji może być różne u poszczególnych pacjentów, zależnie od czynników etiologicznych, stylu życia i odpowiedzi na leczenie²³²⁴.

Przebieg naturalny choroby

Przewlekłe zapalenie trzustki często rozpoczyna się od nawracających epizodów ostrego zapalenia trzustki¹⁶²⁴. Według badań, rozwój PZT z ostrego zapalenia trzustki następuje w czasie od jednego roku do 19 lat²⁴. Tempo progresji jest ściśle związane z częstotliwością i ciężkością ostrych ataków²⁴.

Przebieg choroby można podzielić na kilka etapów²⁵²⁶:

Wczesna faza – charakteryzuje się nawracającymi epizodami bólu, często przypominającymi ostre zapalenie trzustki, z okresami bezbólowymi
Faza pośrednia – ból staje się bardziej stały, pojawiają się pierwsze oznaki niewydolności trzustki
Faza późna – rozwinięte objawy niewydolności zewnątrz- i wewnątrzwydzielniczej, postępujące zwapnienia i włóknienie trzustki

²⁵²⁶

W przebiegu naturalnym choroby występuje znaczna zmienność dotycząca nasilenia bólu. Niektóre badania sugerują, że ból może zmniejszać się wraz z czasem trwania choroby i postępującym zniszczeniem trzustki²⁶. Jednakże inne badania wskazują, że tylko u 48,2% pacjentów ból ustępuje w ciągu 5 lat, a u 66-73% po ponad 5 latach, co oznacza, że co trzeci lub czwarty pacjent nadal cierpi z powodu nawracających ataków bólu nawet po długim okresie obserwacji²⁷.

Czynniki wpływające na progresję

Kilka czynników może wpływać na tempo progresji PZT i nasilenie objawów²⁸²⁹:

Spożywanie alkoholu – kontynuacja spożywania alkoholu po diagnozie znacznie pogarsza przebieg choroby. U około 50-75% pacjentów, którzy zaprzestają spożywania alkoholu, obserwuje się złagodzenie bólu
Palenie tytoniu – zwiększa ryzyko zwapnień trzustki, szczególnie w idiopatycznym późno ujawniającym się PZT
Przebyte ciężkie epizody ostrego zapalenia trzustki – zwłaszcza te związane z pseudotorbielami (występujące u ponad 55% pacjentów)
Cukrzyca typu 2 – pacjenci z już istniejącą cukrzycą typu 2 mają zwiększone ryzyko rozwoju PZT

²⁸²⁹

Ważnym czynnikiem prognostycznym jest również wiek w momencie diagnozy. Młodszy wiek w momencie rozpoznania choroby wiąże się z bardziej agresywnym przebiegiem³⁰.

Powikłania w przebiegu przewlekłego zapalenia trzustki

Wraz z postępem choroby mogą rozwijać się różne powikłania²⁵³⁰:

Niedożywienie – wynika z zaburzeń wchłaniania i przewlekłych biegunki
Pseudotorbiele trzustki – powstają w wyniku gromadzenia się płynu i resztek tkanek
Cukrzyca – wynika z uszkodzenia komórek wytwarzających insulinę
Złogi wapniowe w trzustce – powodują stwardnienie tkanek trzustki
Zwężenie lub niedrożność dróg żółciowych – prowadzące do żółtaczki
Zakrzepica żyły śledzionowej – z wtórnym nadciśnieniem wrotnym
Tętniak rzekomy tętnicy śledzionowej
Zwiększone ryzyko raka trzustki – około 4% pacjentów z PZT rozwinie raka trzustki w ciągu 20 lat

²⁵³⁰

Pacjenci z PZT mają również zwiększone ryzyko rozwoju osteopatii, w tym osteoporozy i osteopenii, co wynika z zaburzeń wchłaniania, stanu zapalnego i czynników związanych ze stylem życia¹⁵.

Progresja objawów klinicznych

W miarę postępu choroby obserwuje się charakterystyczną progresję objawów klinicznych²³:

Ból – początkowo epizodyczny, stopniowo staje się bardziej stały i dokuczliwy. U niektórych pacjentów może zmniejszać się wraz z postępującym zniszczeniem trzustki
Zaburzenia trawienia – pojawiają się stopniowo, nasilając się z czasem. Charakterystyczne stolce tłuszczowe pojawiają się zazwyczaj po kilku latach od początku choroby
Utrata masy ciała – postępująca, wynikająca z nasilających się zaburzeń wchłaniania
Cukrzyca – rozwija się zazwyczaj w późniejszych etapach choroby, po znacznym uszkodzeniu trzustki

²³

Trzustka zazwyczaj traci funkcje zewnątrzwydzielnicze i wewnątrzwydzielnicze dopiero po wielu latach od wystąpienia pierwszych objawów².

Rokowanie i przeżywalność

Rokowanie w PZT jest zróżnicowane i zależy od wielu czynników³⁰³¹. Ogólny wskaźnik przeżywalności wynosi około 70% po 10 latach i 45% po 20 latach od rozpoznania³⁰. Innymi słowy, 10-letnia śmiertelność wynosi 30%, a 20-letnia – 55%.

Czynniki prognostyczne związane z PZT obejmują³⁰:

Wiek w momencie diagnozy
Palenie tytoniu
Kontynuacja spożywania alkoholu
Obecność marskości wątroby

³⁰

Badania sugerują, że większość pacjentów z PZT umiera z powodu innych przyczyn, takich jak nowotwory czy choroby serca¹². Zaprzestanie spożywania alkoholu i palenia tytoniu może zmniejszyć ryzyko tych chorób, a jednocześnie wpłynąć korzystnie na przebieg PZT¹².

PZT zwiększa ryzyko rozwoju raka trzustki. Ryzyko to wynosi około 4% po 20 latach³⁰³², choć niektóre źródła podają, że jest ono 5-10 razy wyższe niż w populacji ogólnej, zwłaszcza u pacjentów, którzy chorowali na PZT przez ponad 10 lat³³.

Zmiany w objawach w czasie

Przewlekłe zapalenie trzustki charakteryzuje się dynamicznymi zmianami w obrazie klinicznym, które zachodzą wraz z progresją choroby. Objawy mogą się zmieniać w czasie, co odzwierciedla postępujące uszkodzenie trzustki i jej funkcji³⁴.

Ewolucja bólu

Charakter bólu w PZT często zmienia się z czasem³⁵²⁶:

Wczesne stadium – ból ma zwykle charakter epizodyczny, przypominający ataki ostrego zapalenia trzustki, z okresami bezbólowymi
Stadium pośrednie – epizody bólu stają się częstsze, a ból między atakami może być bardziej stały
Stadium zaawansowane – ból może przyjmować charakter ciągły, ze sporadycznymi zaostrzeniami

³⁵²⁶

Wzorce bólu mogą ewoluować od epizodycznych do bardziej ciągłych³⁵. Jednakże nagła zmiana charakteru bólu lub jego znaczne zaostrzenie powinno skłaniać do poszukiwania powikłań PZT, takich jak pseudotorbiel, zwężenie dwunastnicy lub dróg żółciowych, czy rozwój wtórnego raka trzustki³⁵.

U niektórych pacjentów wraz ze zniszczeniem trzustki ból może paradoksalnie zmniejszać się lub ustępować, co określa się jako zjawisko „wypalenia” (burn-out)⁸³⁶. Należy jednak zauważyć, że nasilenie bólu nie koreluje z ciężkością uszkodzenia trzustki widocznego w badaniach obrazowych³⁵.

Stopniowy rozwój niewydolności trzustki

Objawy niewydolności zewnątrzwydzielniczej i wewnątrzwydzielniczej trzustki rozwijają się stopniowo¹⁰⁷:

Niewydolność zewnątrzwydzielnicza – staje się klinicznie jawna dopiero po utracie ponad 90% funkcji trzustki, co zwykle następuje co najmniej 5 lat po rozpoznaniu PZT
Niewydolność wewnątrzwydzielnicza – rozwija się zazwyczaj później niż zewnątrzwydzielnicza; liczba osób z PZT, u których rozpoznaje się cukrzycę, wzrasta z czasem, od 25% do 80% w ciągu 10-20 lat od rozpoznania

¹⁰¹²

Początkowo pacjenci mogą nie odczuwać objawów niewydolności trzustki lub są one subtelne. Z czasem dochodzi do nasilenia objawów, takich jak biegunka tłuszczowa, utrata masy ciała i objawy cukrzycy².

Fazy rozwoju choroby

Badacze wyróżniają kilka faz w rozwoju PZT³⁷³⁴:

Wczesna faza – charakteryzuje się nawracającymi epizodami ostrego zapalenia trzustki, z niewielkimi zmianami strukturalnymi w trzustce
Faza pośrednia – pojawiają się pierwsze trwałe zmiany strukturalne, występują epizody bólu, ale funkcja trzustki jest jeszcze względnie zachowana
Zaawansowana faza (ustalona) – obecne są charakterystyczne cechy PZT, w tym zmniejszona funkcja zewnątrzwydzielnicza trzustki, zaburzenia wchłaniania, cukrzyca i zwapnienia trzustki

³⁷³⁴

Należy podkreślić, że wiele cech klinicznych PZT ujawnia się z czasem i może być nieobecnych we wczesnych stadiach choroby³⁴.

Przeżywalność i jakość życia

Wraz z postępem choroby jakość życia pacjentów często się pogarsza³⁸³⁹. Pacjenci doświadczają wyniszczających objawów, które znacząco wpływają na ich codzienne funkcjonowanie.

Długoterminowa prognoza dla przewlekłego zapalenia trzustki może znacznie się różnić w zależności od⁴⁰⁴¹:

Ciężkości choroby
Przestrzegania zaleconego leczenia przez pacjenta
Zaangażowania w zmiany stylu życia

⁴⁰⁴¹

U niektórych osób ból i objawy mogą być dobrze kontrolowane za pomocą leków i dostosowania diety, co pozwala im prowadzić względnie normalne życie. Jednak u innych choroba może postępować, powodując poważne uszkodzenie trzustki i prowadząc do poważnych powikłań⁴⁰.

Z regularną opieką medyczną można śledzić postęp choroby i wyprzedzać jej powikłania²³. Leczenie bólu może stanowić wyzwanie dla niektórych pacjentów i może wpływać na ich zdrowie psychiczne i jakość życia. W takich przypadkach może być rozważana interwencja chirurgiczna²³.

Powikłania oraz rokowanie

Przewlekłe zapalenie trzustki może prowadzić do licznych powikłań, które znacząco wpływają na jakość życia pacjentów i mogą stanowić zagrożenie dla ich zdrowia i życia⁴²¹⁶.

Główne powikłania

Do najczęstszych powikłań PZT należą¹²⁴²³⁷:

Niewydolność zewnątrzwydzielnicza trzustki (PEI) – rozwija się u około 80% pacjentów z czasem i prowadzi do zaburzeń wchłaniania, niedożywienia i utraty masy ciała
Cukrzyca – druga główna komplikacja PZT, wynikająca z uszkodzenia komórek wysp trzustkowych produkujących insulinę
Pseudotorbiele trzustki – tworzą się w wyniku gromadzenia się płynu i resztek tkanek; mogą pękać, powodując infekcję lub krwawienie wewnętrzne
Zwężenie dróg żółciowych – może prowadzić do żółtaczki i nawracających epizodów zaostrzenia zapalenia trzustki
Zwężenie dwunastnicy – powoduje zaburzenia pasażu treści pokarmowej
Zakrzepica żyły śledzionowej – z wtórnym nadciśnieniem wrotnym

¹²⁴²³⁷

Niedrożność dróg żółciowych i dwunastnicy może prowadzić do żółtaczki i zaostrzeń zapalenia trzustki⁴². U pacjentów z PZT istnieje również zwiększone ryzyko rozwoju raka trzustki².

Skutki długotrwałego bólu

Przewlekły ból w przebiegu PZT może prowadzić do poważnych konsekwencji⁴³³³:

Uzależnienie od opioidów – około połowa pacjentów z PZT będzie wymagała leczenia opioidowymi lekami przeciwbólowymi, co może prowadzić do uzależnienia
Depresja i lęk – wynikające z przewlekłego bólu i ograniczeń funkcjonalnych
Obniżona jakość życia – ból jest najczęstszym powodem hospitalizacji lub interwencji endoskopowej lub chirurgicznej i ma najgorszy wpływ na jakość życia

⁴³³³

Około 50% pacjentów z PZT będzie ostatecznie wymagało leczenia chirurgicznego, najczęściej z powodu nieustępującego, wyniszczającego bólu⁴³.

Niedobory żywieniowe

Pacjenci z PZT są narażeni na niedobory żywieniowe z powodu zaburzeń wchłaniania³³⁴⁴:

Niedobory witamin rozpuszczalnych w tłuszczach – A, D, E i K
Utrata masy ciała – nawet przy normalnym apetycie i nawykach żywieniowych
Osteoporoza i osteopenia – związane z niedoborem witaminy D

³³⁴⁴

Utrata masy ciała jest częstym objawem, wynikającym z niedostatecznej produkcji enzymów trzustkowych potrzebnych do trawienia pokarmów, co prowadzi do zaburzeń wchłaniania składników odżywczych²².

Rokowanie długoterminowe

Rokowanie w PZT zależy od wielu czynników, w tym od przyczyny choroby, obecności powikłań i odpowiedzi na leczenie⁴⁵⁴⁶.

Chociaż PZT jest stanem nieuleczalnym, ciężkość, częstotliwość i rodzaj objawów mogą być różne⁴⁵:

U niektórych pacjentów, zwłaszcza tych, którzy całkowicie zaprzestali spożywania alkoholu, objawy są bardzo łagodne lub sporadyczne i łatwo poddają się leczeniu farmakologicznemu
U innych pacjentów, szczególnie tych, którzy nadal spożywają alkohol, może występować upośledzający, codzienny ból, wymagający częstych hospitalizacji

⁴⁵⁴⁶

Komórki trzustki nie regenerują się łatwo po uszkodzeniu. Z tego powodu cukrzyca i inne problemy związane z PZT wymagają długotrwałego leczenia⁴⁵. Nie jest jasne, dlaczego ból rozwija się w przebiegu PZT, ale gdy pojawi się przewlekły ból, zwykle utrzymuje się on długo lub nawet przez całe życie. Wielu pacjentów wymaga długotrwałego leczenia przeciwbólowego⁴⁵.

Jeśli pacjent będzie kontynuował spożywanie alkoholu, a PZT stanie się ciężkie, przewidywana długość życia jest zwykle skrócona o 10-20 lat⁴⁷. Jest to spowodowane powikłaniami zapalenia trzustki lub innymi chorobami związanymi z alkoholem. Jeśli pacjent całkowicie zaprzestanie spożywania alkoholu we wczesnych stadiach choroby, rokowanie jest lepsze⁴⁷.

Ryzyko rozwoju raka trzustki

Przewlekłe zapalenie trzustki zwiększa ryzyko rozwoju raka trzustki²⁴⁸. Ryzyko to jest około 4% po 20 latach trwania choroby³⁰³², choć niektóre źródła podają, że jest ono 5-10 razy wyższe niż w populacji ogólnej³³.

Ryzyko jest szczególnie podwyższone u pacjentów, którzy chorowali na PZT przez ponad 10 lat³³. Stopień ryzyka zależy od podstawowej przyczyny zapalenia trzustki i powinien być omówiony z lekarzem⁴⁹.

Należy podkreślić, że mimo zwiększonego ryzyka, większość osób z PZT nie rozwinie raka trzustki⁴⁸.

Opieka długoterminowa

Ze względu na przewlekły charakter choroby, pacjenci z PZT wymagają długoterminowej opieki medycznej²³²⁹.

Kluczowe elementy długoterminowej opieki obejmują⁵⁰⁵¹:

Regularne wizyty kontrolne – umożliwiające monitorowanie progresji choroby i wczesne wykrywanie powikłań
Długoterminowe leczenie przeciwbólowe – dostosowane do indywidualnych potrzeb pacjenta
Suplementację enzymów trzustkowych – aby wspomóc trawienie
Zmiany dietetyczne – najczęściej dieta niskotłuszczowa, bogata w składniki odżywcze
Regularne badania przesiewowe w kierunku raka trzustki
Monitorowanie i leczenie cukrzycy – jeśli się rozwinie

⁵⁰⁵¹

W ciężkich przewlekłych przypadkach (tzw. martwiczym zapaleniu trzustki) może być konieczne leczenie chirurgiczne w celu usunięcia martwej lub zakażonej tkanki trzustkowej⁵⁰.

Chociaż PZT może mieć poważne i długotrwałe skutki, przy odpowiedniej diagnostyce i leczeniu objawów oraz wprowadzeniu pewnych zmian w stylu życia, takich jak abstynencja od alkoholu i zaprzestanie palenia, pacjenci mogą prowadzić długie i względnie normalne życie²⁵⁴¹.

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

Materiały źródłowe

#1 Pancreatitis: Symptoms, Causes & Treatment
https://my.clevelandclinic.org/health/diseases/8103-pancreatitis
Chronic pancreatitis is a long-term, progressive condition. It doesn’t go away and gets worse over time. It happens when the injury or damage to your pancreas never stops. Chronic pancreatitis will eventually do lasting damage to your pancreas, although it may take many years. Constant inflammation causes scarring of your pancreas tissues (fibrosis), which stops them from making enzymes and hormones. […] Additional symptoms of chronic pancreatitis may include: Indigestion and pain after eating. Loss of appetite and unintended weight loss. Fatty poops that leave an oily film in the toilet. Lightheadedness (from low blood pressure). These are symptoms of your pancreatic functions beginning to break down. […] With chronic pancreatitis, the pain may vary in intensity. It may come and go, but it typically doesn’t go away completely. You may notice it more after eating. For some people, the pain is constant.
#2
https://www.nhs.uk/conditions/chronic-pancreatitis/
Chronic pancreatitis is a condition where the pancreas has become permanently damaged from inflammation and stops working properly. […] The most common symptom of chronic pancreatitis is repeated episodes of severe pain in your tummy (abdomen). […] As the condition progresses, the painful episodes may become more frequent and severe. […] Eventually, a constant dull pain can develop in your tummy, between episodes of severe pain. […] Other symptoms develop as the damage to the pancreas progresses and it becomes unable to produce digestive juices, which help to break down food. […] The pancreas usually only loses these functions many years after the first symptoms started. […] You may also experience weight loss, loss of appetite, yellowing of the skin and eyes (jaundice), symptoms of diabetes such as feeling very thirsty, needing to pee more often than usual and feeling very tired, ongoing nausea and sickness (vomiting). […] Chronic pancreatitis increases your risk of pancreatic cancer, although the chance is still small.
#3 Chronic pancreatitis | NHS inform
https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/chronic-pancreatitis/
Chronic pancreatitis is a condition where the pancreas (a small organ located behind the stomach and below the ribcage) becomes permanently damaged from inflammation. […] The most common symptom of chronic pancreatitis is repeated episodes of abdominal (tummy) pain, which can be severe. […] Other symptoms tend to develop as the damage to the pancreas progresses, such as producing greasy, foul-smelling stools. […] The pain usually develops in the middle or left side of the abdomen and can sometimes travel along your back. Its been described as a burning or shooting pain which comes and goes, but can last for several hours or days, in some cases. […] As chronic pancreatitis progresses, the painful episodes may become more frequent and severe. […] Eventually, a constant mild to moderate pain can develop in the abdomen in between episodes of severe pain. This is most common in people who continue to drink alcohol after being diagnosed with chronic pancreatitis.
#4 Patient education: Chronic pancreatitis (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/chronic-pancreatitis-beyond-the-basics/print
Chronic pancreatitis occurs when the pancreas becomes damaged by long-standing inflammation. Inflammation changes the pancreas’ ability to function normally. People with chronic pancreatitis require ongoing medical care to minimize their symptoms, slow the damage to the pancreas, and address any complications that arise. In most cases, treatment controls but does not cure the underlying problem. […] The most common symptom of chronic pancreatitis is long-standing pain in the middle of the abdomen. You may also have episodes when the pancreas suddenly becomes inflamed and your pain suddenly worsens (called acute pancreatitis). […] People with chronic pancreatitis can have difficulty digesting fats in foods; this can lead to weight loss and occasionally diarrhea. In severe cases, the pancreas loses its ability to produce enough insulin, leading to diabetes.
#5 Chronic pancreatitis – Guts UK
https://gutscharity.org.uk/advice-and-information/conditions/chronic-pancreatitis/
The major symptoms of chronic pancreatitis are: Pain, Nausea, Vomiting, Diarrhoea, Weight loss, Fatigue. Some people with chronic pancreatitis have only one or two of these symptoms. Symptoms of diabetes may happen late in the disease. […] The pain of chronic pancreatitis can range from mild to severe and is felt across the upper abdomen. Chronic pancreatitis causes upper abdominal pain (just below the ribs) that can range in intensity from mild to severe. Additionally, the pain could radiate to the back. Some people get relief from crouching forwards. Eating can make the pain worse. The pain may be constant, or it may come and go. Some people also get attacks of acute pancreatitis or flares in their painful symptoms. Painless chronic pancreatitis occurs in 1 in 10 people with chronic pancreatitis. This is particularly true of people with idiopathic and genetic causes of their pancreatitis. This means most people with chronic pancreatitis will experience pain.
#6 Chronic pancreatitis – Wikipedia
https://en.wikipedia.org/wiki/Chronic_pancreatitis
There have been three pain symptom profiles described in those with chronic pancreatitis. Type A involves intermittent, severe symptom flare-ups with or without objective pancreatitis separated by pain-free periods. The type A symptom profile is usually more common early in the course of chronic pancreatitis. Type B chronic pancreatitis involves chronic pain accompanied by intermittent severe attacks. And, the type C symptom profile of chronic pancreatitis involves chronic, long-term, severe pain without interspersed acute flare-ups or symptom exacerbations.
#7 Patient education: Chronic pancreatitis (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/chronic-pancreatitis-beyond-the-basics/print
Abdominal pain usually occurs in the upper abdomen, often spreads to the back, may be relieved by sitting up or leaning forward, and may be associated with nausea and vomiting. The pain is often worse 15 to 30 minutes after a meal. However, up to 20 percent of people with chronic pancreatitis do not have any pain at all. […] The pancreas normally helps to digest food and control blood sugar levels. In people with chronic pancreatitis, the pancreas may not function normally, leading to difficulty processing fat in the diet (exocrine pancreatic insufficiency). This can cause loose, greasy, foul-smelling stools that are difficult to flush. This can lead to vitamin and nutrient deficiencies, including weight loss. These symptoms do not usually develop until the pancreas loses about 90 percent of its function. In addition, diabetes may develop after years of chronic pancreatitis (endocrine insufficiency).
#8 Chronic Pancreatitis – Digestive Disorders – Merck Manual Consumer Version
https://www.merckmanuals.com/home/digestive-disorders/pancreatitis/chronic-pancreatitis
Chronic pancreatitis is long-standing inflammation of the pancreas that results in irreversible deterioration of the structure and function of the pancreas. […] Abdominal pain is the main symptom of chronic pancreatitis. The upper abdominal pain may vary in intensity, and flare-ups (bouts or attacks) may last for many hours or several days. Later on in the illness, pain tends to become constant. The pain is usually worse after meals and may be lessened by sitting upright or leaning forward. […] As chronic pancreatitis progresses and the cells that secrete the digestive enzymes are destroyed, the abdominal pain may stop. […] Pancreatic insufficiency is the other main symptom of chronic pancreatitis. Pancreatic insufficiency is a decrease in the amount of digestive enzymes in pancreatic fluid. As the amount of digestive enzymes decreases, food is inadequately broken down. Food that is inadequately broken down is not absorbed properly (malabsorption), and the person may produce bulky, unusually foul-smelling, greasy stools (steatorrhea). The stool is light-colored and may even contain oil droplets. The inadequate absorption of food also leads to undernutrition, vitamin deficiencies, and weight loss.
#9 Pancreatitis: Symptoms, Causes & Treatment
https://my.clevelandclinic.org/health/diseases/8103-pancreatitis
When long-term, chronic pancreatitis begins to affect your pancreatic function, you’ll notice it in your digestive system first. When your pancreas can no longer make and deliver its digestive enzymes, your body won’t be able to break down and absorb all the nutrients from your food. You may feel discomfort after eating and may begin passing undigested fats in your poop. Over time, you may notice weight loss. […] Chronic pancreatitis will also cause your pancreas to produce less of the hormones that regulate your blood sugar (glucose). Depending on which is affected first, you may experience symptoms from a lack of glucagon, which causes hypoglycemia (low blood sugar), or from a lack of insulin, which causes hyperglycemia (high blood sugar). Eventually, both hormone supplies are depleted, and diabetes develops.
#10 Chronic Pancreatitis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK482325/
Chronic pancreatitis typically presents with prolonged abdominal pain, often with intermittent pain-free periods. The pain may improve when leaning forward. However, some patients remain asymptomatic. Common symptoms include nausea, vomiting, diarrhea, steatorrhea (greasy, foul-smelling, difficult-to-flush stools), and weight loss. As the disease progresses, glucose intolerance or pancreatic diabetes may develop. […] Exocrine pancreatic insufficiency, characterized by steatorrhea and azotorrhea, becomes clinically evident after over 90% of pancreatic function is lost. This condition typically manifests at least 5 years after the diagnosis of chronic pancreatitis. […] Chronic pancreatitis can lead to various complications due to ongoing pancreatic damage and dysfunction. These complications include exocrine pancreatic insufficiency, which typically occurs later in the course of chronic pancreatitis, often no sooner than 5 years after diagnosis.
#11 Chronic pancreatitis | NHS inform
https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/chronic-pancreatitis/
Additional symptoms can occur when the pancreas loses its ability to produce digestive juices, which help to break down food in the digestive system. […] The absence of digestive juices makes it difficult for your digestive system to break down fats and certain proteins. This can cause your stools to become particularly smelly and greasy, and make them difficult to flush down the toilet. […] You may also experience weight loss, loss of appetite, jaundice (yellowing of the skin and eyes), symptoms of diabetes such as feeling very thirsty, urinating frequently and feeling very tired, ongoing nausea and vomiting.
#12 Chronic pancreatitis – Guts UK
https://gutscharity.org.uk/advice-and-information/conditions/chronic-pancreatitis/
The number of people with chronic pancreatitis who are diagnosed with diabetes increases over time. 25 people in 100 to 80 people in 100 will develop diabetes within 10 to 20 years. […] 8 in 10 people with chronic pancreatitis will develop pancreatic exocrine insufficiency (PEI) over time. This is poor absorption of food due to a lack of digestive enzymes resulting from the damaged pancreas being unable to produce enough. […] The two main complications of chronic pancreatitis are diabetes and PEI. […] People may worry about whether they will die from chronic pancreatitis. The likelihood is low. Research suggests most people die from other causes such as cancer or heart disease. Drinking alcohol and smoking are factors that you can try to stop in order to reduce your risk of these diseases. As these factors also risk worsening chronic pancreatitis, it is a good idea to stop if this applies to you.
#13 Signs, symptoms and management of pancreatitis – The Pharmaceutical Journal
https://pharmaceutical-journal.com/article/ld/signs-symptoms-and-management-of-pancreatitis
Chronic pancreatitis is chronic, irreversible inflammation and fibrosis of the pancreas. Patients often present with severe pain and symptoms related to endocrine and exocrine insufficiency. […] Patients with chronic pancreatitis can also experience symptoms of pancreatic endocrine and exocrine insufficiency. Endocrine insufficiency can lead to non-diabetic hyperglycaemia owing to damage to the islets of Langerhans and is characterised by a deficiency of insulin. Exocrine insufficiency can present as maldigestion and malabsorption owing to damage of the acinar cells, which are responsible for synthesising, storing and secreting digestive enzyme. […] By contrast, the management of chronic pancreatitis focuses on addressing the progressive endocrine and exocrine insufficiency. Possible complications include pancreatogenic diabetes, chronic pain and malnutrition. Patients with chronic pancreatitis are at risk of malabsorption, malnutrition and a deterioration in their quality of life, and an assessment with a dietician should be considered.
#14
https://111.wales.nhs.uk/encyclopaedia/p/article/pancreatitis(chronic)/
Chronic pancreatitis is a condition where the pancreas has become permanently damaged from inflammation and stops working properly. […] The most common symptom of chronic pancreatitis is repeated episodes of severe pain in your tummy (abdomen). […] As the condition progresses, the painful episodes may become more frequent and severe. […] Eventually, a constant dull pain can develop in your tummy, between episodes of severe pain. […] Other symptoms develop as the damage to the pancreas progresses and it becomes unable to produce digestive juices, which help to break down food. […] The absence of digestive juices means it’s harder to break down fats and some proteins. […] You may also experience weight loss, loss of appetite, yellowing of the skin and eyes (jaundice), symptoms of diabetes such as feeling very thirsty, needing to pee more often than usual and feeling very tired, ongoing nausea and sickness (vomiting). […] The pancreas usually only loses these functions many years after the first symptoms started.
#15 Chronic pancreatitis – Wikipedia
https://en.wikipedia.org/wiki/Chronic_pancreatitis
Chronic pancreatitis is a long-standing inflammation of the pancreas that alters the organ’s normal structure and functions. It can present as episodes of acute inflammation in a previously injured pancreas, or as chronic damage with persistent pain or malabsorption. It is a disease process characterized by irreversible damage to the pancreas as distinct from reversible changes in acute pancreatitis. Tobacco smoke and alcohol misuse are two of the most frequently implicated causes, and the two risk factors are thought to have a synergistic effect with regards to the development of chronic pancreatitis. Chronic pancreatitis is a risk factor for the development of pancreatic cancer. […] Upper abdominal pain which increases after drinking or eating, lessens when fasting or sitting and leaning forward. Some people may not suffer pain. Nausea and vomiting. Steatorrhea: Frequent, oily, foul-smelling bowel movements. Damage to the pancreas can reduce the production of pancreatic enzymes that aid digestion, causing Exocrine Pancreatic Insufficiency. Fats and nutrients are not absorbed properly, leading to loose, greasy stool known as steatorrhea. It can also lead to malnutrition. Weight loss even when eating habits and amounts are normal. Type 3c diabetes (pancreatogenic diabetes): Chronic pancreatitis can affect the ability of the pancreatic islets to produce insulin to regulate glucose levels, leading to diabetes type 3c. Symptoms of diabetes type 3c are due to elevated sugar and may include increased hunger and thirst, frequent urination, weight loss, fatigue, and blurry vision. Osteopathy: Chronic pancreatitis is associated with an increased risk of osteopathy, including osteoporosis and osteopenia. Malnutrition, inflammation, and lifestyle factors contribute to the high prevalence of bone disorders in chronic pancreatitis patients.
#16 Chronic pancreatitis: Symptoms, causes, and more
https://www.medicalnewstoday.com/articles/160459
Chronic pancreatitis may begin as a result of recurring acute pancreatitis, which is a sudden and severe form of the condition. It can persist after the acute phase passes, causing progressive and permanent damage to the pancreas. […] The symptoms of chronic pancreatitis can include: severe upper abdominal pain that can sometimes travel along the back and may be more intense following a meal, nausea, vomiting. […] For periods of time, people with chronic pancreatitis can have no symptoms. At other times, the pain may be constant. As the condition progresses, the episodes of pain become more frequent and severe. […] As the ability of the pancreas to produce digestive enzymes deteriorates, a person may develop: bloating, abdominal cramps, smelly, greasy stools, flatulence. […] Eventually, the pancreas may not be able to produce insulin, leading to type 1 diabetes, which can cause: thirst, frequent urination, intense hunger, unintentional weight loss, tiredness, blurred vision. […] Chronic pancreatitis is a serious condition that can undermine a person’s overall health and shorten their life span. It can lead to pancreatic cancer, diabetes, and other chronic conditions. […] Early diagnosis and treatment are critical for prolonging a person’s life and easing their pain.
#17 Pancreatitis: Symptoms, Causes, and Treatments
https://www.healthline.com/health/pancreatitis
Chronic pancreatitis is an inflammation of the pancreas that comes back consistently or occurs over a long period of time. […] People with chronic pancreatitis can have permanent damage to their pancreas and other complications. Scar tissue develops from this continuing inflammation. […] Pancreatitis can damage cells that produce insulin. Insulin is a hormone the pancreas releases to regulate the amount of sugar in your blood. When pancreatitis damages these cells, it leads to diabetes in about 45 percent of people with chronic pancreatitis. […] Some people who have chronic pancreatitis may show inflammation on diagnostic imaging scans, but they may show no symptoms otherwise. […] Chronic pancreatitis symptoms include pain in the upper abdomen or no pain at all, pain that may spread to the back, pain that may become worse after eating, diarrhea, nausea, weight loss, and vomiting. […] People who have chronic pancreatitis may also experience steatorrhea, which is fatty stools that give off a foul odor. […] Long-term heavy alcohol use can cause pancreatitis in adults. Autoimmune and genetic diseases, such as cystic fibrosis, can also cause chronic pancreatitis in some people.
#18 Chronic Pancreatitis: Causes, Symptoms, & Treatment
https://www.healthline.com/health/chronic-pancreatitis
Chronic pancreatitis has the potential to cause numerous complications. […] Nutrient malabsorption is one of the most common complications. […] The development of diabetes is another possible complication. […] About 45 percent of people with chronic pancreatitis will get diabetes. […] The outlook depends on the severity and underlying cause of the disease. […] Prompt diagnosis and treatment can improve the outlook.
#19 Acute and chronic pancreatitis – Mayo Clinic Health System
https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/breaking-down-pancreatitis
Pancreatitis that occurs over many years can damage your pancreas and lead to chronic pancreatitis. It causes permanent damage and scarring of the pancreas. Chronic pancreatitis can lead to weight loss, pain, diabetes and pancreatic cancer. […] Chronic pancreatitis symptoms include: Upper abdominal pain, Indigestion, Abdominal pain that worsens after eating, Unexpected weight loss, Oily, smelly stools called steatorrhea, Jaundice, which is yellowing of the eyes and skin, Development of diabetes. […] Treating chronic pancreatitis may involve changes to your diet, pain management, and taking enzymes to improve digestion.
#20 Pancreatitis – symptoms, causes and treatment | healthdirect
https://www.healthdirect.gov.au/pancreatitis
Pancreatitis is inflammation of your pancreas that is usually mild, but if severe, can be life threatening. […] In chronic (ongoing) pancreatitis you may have longstanding mid-abdominal pain. […] The most common symptom of chronic pancreatitis is long-standing pain in the middle of your abdomen. If you have chronic pancreatitis, you might get repeated episodes of acute pancreatitis, where your pain gets worse. Your pain may get worse with eating, drinking and drinking alcohol. You may also develop jaundice. […] If you have chronic pancreatitis, you can have trouble digesting food, particularly fats, because of your lack of digestive juices. This can lead to vitamin and mineral deficiencies, and other symptoms including: diarrhoea, weight loss, loose, greasy, foul-smelling stools. […] In severe cases, your pancreas may not produce enough insulin, leading to diabetes. Chronic pancreatitis is a risk factor for pancreatic cancer.
#21 Pancreatitis – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/pancreatitis/symptoms-causes/syc-20360227
Chronic pancreatitis signs and symptoms include: […] Some people with chronic pancreatitis only develop symptoms after they get complications of the disease.
#22 Chronic Pancreatitis â National Pancreas Foundation
https://pancreasfoundation.org/pancreas-disease/chronic-pancreatitis/
Chronic pancreatitis is a progressive disorder associated with the destruction of the pancreas. The disease is more common in men and usually develops in persons between 30 and 40 years of age. Initially, chronic pancreatitis may be confused with acute pancreatitis because the symptoms are similar. […] Most individuals with chronic pancreatitis experience upper abdominal pain, although some have no pain at all. The pain may spread to the back, become worse with eating or drinking and become constant and disabling. In some cases, the abdominal pain goes away as the condition worsens, but this is uncommon. […] Individuals with chronic pancreatitis frequently lose weight, even when their appetite and eating habits are normal. The weight loss occurs because the body does not secrete enough pancreatic enzymes to digest food, so nutrients are not absorbed normally, leading to malnutrition. Patients who have chronic pancreatitis may have a decreased quality of life due to pain and often require admission to the hospital for treatment of symptoms. […] People with chronic pancreatitis may not have symptoms until they have complications.
#23 Pancreatitis: Symptoms, Causes & Treatment
https://my.clevelandclinic.org/health/diseases/8103-pancreatitis
Chronic pancreatitis is a slow-progressing disease. With regular care, you can keep track of its progression and stay ahead of its complications. Pain management can become a challenge for some people, and it can also affect your mental health and quality of life. When this is the case, surgery might be an option. You can live without your pancreas, although it may make you insulin-dependent.
#24 Progression of alcoholic acute to chronic pancreatitis. | Gut
https://gut.bmj.com/content/35/4/552
Alcoholic chronic pancreatitis usually progresses from acute attacks to chronic pancreatitis within one to 19 years. […] The yearly incidence of acute attacks of pancreatitis was significantly higher in groups (a) and (b) than in group (c). Furthermore, the progression rate to advanced chronic pancreatitis (groups (a) and (b)) correlated with the incidence of severe pancreatitis (associated with pseudocysts in more than 55%). […] In conclusion, these data suggest that the progression of acute to chronic pancreatitis is closely related to the incidence and severity of acute attacks.
#25 Chronic Pancreatitis Treatment Options in Anchorage, AK
https://www.farnorthsurgery.com/blog/chronic-pancreatitis-treatment-options-anchorage
Chronic pancreatitis caused by excessive alcohol abuse can be classified into 4 stages. […] As the disease advances, the insulin-producing cells of the pancreas suffer extensive damage due to which you may face certain complications such as: Long-term pain and inflammation, Recurring episodes of acute pain, Nutrient malabsorption occurs due to reduced production of digestive enzymes and can cause malnutrition, Calcium deposits within the pancreas harden the pancreatic tissues, Gallstones, Diabetes due to damage to the cells that produce insulin and glucagon, Kidney failure, Pseudocysts are caused by the accumulation of fluid and tissue debris, Pancreatic cancer. […] While chronic pancreatitis can have long-term and serious effects, with proper diagnosis and treatment of your symptoms and making certain lifestyle changes such as abstaining from alcohol and smoking, you can live a long and normal life.
#26 Natural Course of Chronic Pancreatitis | Pancreapedia
https://pancreapedia.org/reviews/natural-course-of-chronic-pancreatitis
In the minority of patients (i.e., 5.8% to 20%), chronic pancreatitis takes a primarily painless course. Exocrine and endocrine insufficiency are the dominating symptoms. For the majority of patients, however, pain is the decisive symptom, causing much discomfort in their daily lives. […] Some studies have correlated the course of pain in chronic pancreatitis with the duration of the disease, progressing exocrine and endocrine pancreatic insufficiency and morphological changes, such as pancreatic calcification and duct abnormalities. Furthermore, the course of pain has been studied following alcohol abstinence and after surgery in some groups. […] Whether progressive parenchymal destruction leads to pain decrease has been repeatedly debated. Ammanns group has claimed that pain decreases with increasing duration of the disease. In one long-term study, 85% of 145 patients with chronic pancreatitis felt no more pain after 4.5 years (median) than at the onset of the disease.
#27 Natural Course of Chronic Pancreatitis | Pancreapedia
https://pancreapedia.org/reviews/natural-course-of-chronic-pancreatitis
The reports from Zurich are at variance with the studies from Japan and Germany. Miyake et al. found that only 48.2% of the patients with chronic pancreatitis became free of pain within 5 years, but 6673% after more than 5 years. This showed that every third or fourth patient still suffered from relapsing pain attacks even after a long observation period. […] The Swiss group have repeatedly observed pain decrease when exocrine and endocrine pancreatic function declines. Similarly, Girdwood et al. reported from South Africa that pain decreased as exocrine pancreatic function deteriorated. […] Thus, according to these results, the progression of exocrine and endocrine pancreatic insufficiency has a limited influence, if any, on the course of pain in chronic pancreatitis. […] The Swiss group showed an increased incidence of pancreatic calcifications, which in turn was associated with pain decrease. However, in a later survey the same group reported a regression of pancreatic calcifications in a long-term study of patients with chronic pancreatitis. Thus, the prognostic role of pancreatic calcifications in determining the course of pain is unclear.
#28 Natural Course of Chronic Pancreatitis | Pancreapedia
https://pancreapedia.org/reviews/natural-course-of-chronic-pancreatitis
Smoking has an effect on the natural course of the disease since it increases the risk of pancreatic calcification in late-onset but not early-onset idiopathic chronic pancreatitis. […] Since alcoholism is the leading etiologic factor in chronic pancreatitis, several studies have investigated whether alcohol abstinence influences pain or progression of the disease. Sarles and Sahel reported that 50% of their patients with chronic pancreatitis experienced pain relief when alcohol abuse was discontinued, whereas Trapnell reported a figure of 75% when alcohol abuse was discontinued. […] Pain relief was obtained in 52% of these patients, whereas spontaneous relief in alcoholics was seen in 37%. Thus, alcohol abstinence will probably lead to some improvement of pain in every second patient with chronic pancreatitis, but why exactly abstinence helps in some cases but not in others remains to be investigated.
#29 Long-term view for chronic pancreatitis | I.M. Matters from ACP
https://immattersacp.org/archives/2014/01/pancreatitis.htm
Once the diagnosis is clear, most internists should be able to handle many patients with the condition. […] Patients who have had prior, recurrent acute pancreatitis are at increased risk for chronic pancreatitis. […] Depending on the severity of the attacks of acute pancreatitis, there can be damage to the small or main ducts in the pancreas that lead to scarring and other changes that lead to chronic pancreatitis. […] Dr. Tenner noted that patients with established type 2 diabetes have increased risk for chronic pancreatitis. […] Although chronic pancreatitis is not reversible, patients can help prevent progression by avoiding behavior that can worsen it, notably alcohol consumption and smoking. […] Dietary adjustments can help alleviate pain. […] The next step is medication.
#30 Chronic Pancreatitis: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/181554-overview
The prognostic factors associated with chronic pancreatitis are age at diagnosis, smoking, continued use of alcohol, and the presence of liver cirrhosis. The overall survival rate is 70% at 10 years and 45% at 20 years. In an international study, 559 deaths occurred among patients with chronic pancreatitis, compared with an expected number of 157, which creates a standard mortality ratio of 3.6. Taking the opposite view, the 10-year mortality rate is 30%, and the 20-year mortality rate is 55%. The risk of developing pancreatic cancer is approximately 4% at 20 years. […] The most common complications of chronic pancreatitis are pseudocyst formation and mechanical obstruction of the duodenum and common bile duct. Less frequent complications include pancreatic ascites or pleural effusion, splenic vein thrombosis with portal hypertension, and pseudoaneurysm formation of the splenic artery.
#31 Chronic Pancreatitis – Digestive Disorders – Merck Manual Consumer Version
https://www.merckmanuals.com/home/digestive-disorders/pancreatitis/chronic-pancreatitis
The prognosis for chronic pancreatitis varies. […] Pain control is the most challenging part of managing chronic pancreatitis, and treatments are focused on reducing pain and slowing disease progression. Eating 4 or 5 meals a day consisting of food low in fat may reduce secretion of pancreatic enzymes and reduce pain. […] Pancreatic enzyme supplementation may reduce chronic pain by reducing the secretion of pancreatic enzymes. Although enzyme therapy is often tried because it is safe and has few side effects, it may not provide substantial pain relief. […] For people who have pancreatic insufficiency, taking tablets or capsules of pancreatic enzyme extracts with meals can make the stool less greasy and improve food absorption, but these problems are rarely eliminated.
#32
https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=uf4337
If much of the tissue in the pancreas has died, you may not get enough nutrients. So you may become malnourished. This happens because the pancreas no longer makes the enzymes needed to digest fat and protein. So fat is released into your stool. This condition, called steatorrhea, causes loose, pale, very foul-smelling stools. The stools may float in the toilet bowl. […] If the damaged pancreas stops making enough insulin, you also may get diabetes. […] Chronic pancreatitis raises your risk for pancreatic cancer. About 4 out of 100 people with chronic pancreatitis get this cancer.
#33 Long-term view for chronic pancreatitis | I.M. Matters from ACP
https://immattersacp.org/archives/2014/01/pancreatitis.htm
Several studies indicate that approximately half of all patients with chronic pancreatitis will be treated with opioids. […] Unfortunately with narcotics, there can be problems with dependency. […] Supplementation with pancreatic enzymes may also help with pain. […] Patients with chronic pancreatitis are at increased risk for conditions related to deficiencies in vitamins A, D and E, particularly bone loss due to vitamin D malabsorption. […] The risk of pancreatic cancer in these patients is usually about 5- to 10-fold that of people without chronic pancreatitis, especially in patients who have had chronic pancreatitis for more than 10 years. […] Diabetes is one of the cardinal symptoms of chronic pancreatitis. […] Diabetes is seen in 20% to 60% patients with chronic pancreatitis.
#34 Chronic pancreatitis: Clinical manifestations and diagnosis in adults – UpToDate
https://www.uptodate.com/contents/chronic-pancreatitis-clinical-manifestations-and-diagnosis-in-adults/print
Chronic pancreatitis can result from episodes of acute pancreatitis of any cause, most commonly in those with multiple relapsing episodes of acute pancreatitis. […] The syndrome of chronic pancreatitis results from exposure to risk factors (genetic and environmental) and is characterized by derangements in pancreatic function (digestive function or insulin secretion), and structural changes in the pancreas visible on imaging or endoscopic studies. […] However, many of the clinical features take time to manifest and may be absent in the early stages of chronic pancreatitis. […] Abdominal pain is the most common clinical symptom in chronic pancreatitis. The pain is most commonly felt in the epigastric region and often radiates to the back. […] The pattern of abdominal pain varies among patients. While some patients may experience constant pain of variable severity with periodic exacerbations, others have ongoing relentless and severe pain.
#35 Chronic pancreatitis: Clinical manifestations and diagnosis in adults – UpToDate
https://www.uptodate.com/contents/chronic-pancreatitis-clinical-manifestations-and-diagnosis-in-adults/print
Pain patterns can change over time, most commonly evolving from episodic to more continuous pain. […] However, a change in pain pattern or sudden worsening of pain should also prompt a search for a complication of chronic pancreatitis, such as a pseudocyst, duodenal or biliary obstruction, or secondary pancreatic carcinoma. […] The presence of pain or its severity does not correlate with the severity of damage to the pancreas on imaging studies. […] Pain is the most common reason for hospitalization or for endoscopic or surgical intervention, and the most deleterious for quality of life.
#36 Chronic Pancreatitis: Symptoms, Causes and Treatment | Ada
https://ada.com/conditions/chronic-pancreatitis/
Chronic pancreatitis is a continuing, chronic, and irreversible inflammatory process of the pancreas without the possibility of healing, which worsens over time, leading to permanent damage and tissue scarring. […] Symptoms of chronic pancreatitis are pain in the upper abdomen, nausea, and vomiting. […] The most common symptom of chronic pancreatitis is very strong pain in the abdomen, often in the mid-abdomen or left upper abdomen area, and that can radiate to the mid-back area. […] A small number of people may report that their pain decreases as the condition progresses, a phenomenon referred to as burn-out. […] Other symptoms of chronic pancreatitis can include: nausea, vomiting, diarrhea, greasy-looking, bad-smelling stools, pale or clay-colored stools, weight loss, flatulence, distended abdomen, tiredness.
#37 Chronic pancreatitis – Symptoms, diagnosis and treatment | BMJ Best Practice US
https://bestpractice.bmj.com/topics/en-us/67
Chronic pancreatitis is most commonly associated with chronic alcohol ingestion (75%). […] Hallmark features are epigastric abdominal pain radiating to the back, steatorrhea, malnutrition, and diabetes mellitus. […] Chronic pancreatitis is characterized by recurrent or persistent abdominal pain and progressive injury to the pancreas and surrounding structures, resulting in scarring and loss of function. […] Established chronic pancreatitis: hallmark features of chronic pancreatitis are present, including reduced pancreatic exocrine function, malabsorption, diabetes, and pancreatic calcifications. […] Common complications include opioid addiction, pancreatic pseudocysts, pancreatic calcification, diabetes mellitus, and malabsorption.
#38 Chronic Pancreatitis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK482325/
Chronic pancreatitis is a progressive fibroinflammatory disease characterized by irreversible damage to the pancreatic tissue, resulting in exocrine and endocrine dysfunction. Over time, normal pancreatic parenchyma is replaced by fibrotic tissue, causing chronic abdominal pain, malabsorption due to exocrine insufficiency, and diabetes mellitus. As the disease progresses, patients often experience debilitating symptoms that significantly impact their quality of life. […] Chronic pancreatitis is a progressive inflammatory disease affecting both pancreatic functions. Exocrine dysfunction leads to pancreatic insufficiency, steatorrhea, and weight loss, occurring when over 90% of the organ is damaged. In severe cases, pancreatic insufficiency affects up to 85% of patients. Endocrine dysfunction results in pancreatogenic diabetes, also known as type 3c diabetes.
#39 Chronic Pancreatitis â Symptoms, and Treatment
https://allieddigestivehealth.com/chronic-pancreatitis-symptoms-and-treatment/
Other symptoms could include nausea, vomiting, and a tendency to develop diabetes, as the insulin-producing cells in the pancreas may be damaged. Chronic Pancreatitis, if not appropriately managed, can lead to several complications that can significantly impact a patientâs quality of life. One common complication is Pancreatic Insufficiency, where the pancreas can no longer produce enough enzymes for proper digestion, leading to malnutrition and weight loss. […] Thereâs also an increased risk of developing diabetes, as damage to the insulin-producing cells in the pancreas can result in reduced insulin production. The long-term outlook for chronic pancreatitis can vary significantly, depending on the severity of the disease, the patientâs adherence to prescribed treatments, and their commitment to lifestyle changes. Pain and symptoms can be well-managed for some people with medication and dietary adjustments, allowing them to lead relatively normal lives. However, for others, the disease might progress, causing severe damage to the pancreas and leading to serious complications. […] If youâre experiencing persistent abdominal pain, unexplained weight loss, or changes in your stool, itâs important to consult your doctor immediately.
#40 Chronic Pancreatitis â Symptoms, and Treatment
https://allieddigestivehealth.com/chronic-pancreatitis-symptoms-and-treatment/
#41 How We Diagnose and Treat Patients with Chronic Pancreatitis
https://www.medstarhealth.org/blog/chronic-pancreatitis
In severe cases, pancreatitis attacks can lead to unintended weight loss and severe dehydration, made worse by the fact that you may not be able to drink water and get rehydrated without vomiting again. If you notice these symptoms, get to an emergency room as soon as possible for treatment. […] Without proper care, chronic pancreatitis can lead to serious problems, such as severe pain and malnutrition. Over the long term, people with this condition are at risk for developing diabetes and pancreatic cancer. […] Chronic pancreatitis can have serious and long-lasting effects. But with lifestyle changes and effective treatments, patients with this condition can reduce their pain and live a more normal life.
#42 Patient education: Chronic pancreatitis (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/chronic-pancreatitis-beyond-the-basics/print
Chronic pancreatitis can lead to a variety of complications, including blockage of the ducts that drain the pancreas and gallbladder, which can lead to jaundice (yellowing of the skin) and bouts of worsening pancreatitis, blockage of the upper intestine, and an increased risk of pancreatic cancer. […] Treatment of chronic pancreatitis can help to relieve pain, improve pancreatic function, and manage complications. […] Some studies suggest that early surgery slows the progression of chronic pancreatitis, while others suggest that the condition worsens even in people who have surgery early.
#43 Chronic Pancreatitis: Diagnosis and Treatment | AAFP
https://www.aafp.org/pubs/afp/issues/2018/0315/p385.html
Chronic pancreatitis is an irreversible and progressive disorder of the pancreas characterized by inflammation, fibrosis, and scarring. Exocrine and endocrine functions are lost, often leading to chronic pain. […] Chronic pancreatitis is a permanent, progressive destruction of pancreatic tissue and function. Clinical manifestations include disabling abdominal pain, steatorrhea, and diabetes mellitus. […] Patients most commonly present with recurrent episodes of acute pancreatitis. This will often progress to chronic abdominal pain that is characteristically located in the epigastrium and radiates to the back. The pain is worsened by eating and relieved by leaning forward. In time, it may spontaneously resolve as the pancreas fails. […] Disabling pain is the most common symptom of chronic pancreatitis. Because treatment with narcotic pain medications can lead to opioid addiction, beginning with nonsteroidal anti-inflammatory drugs or acetaminophen is recommended. Adding narcotic pain medications in a stepwise approach may be necessary to obtain adequate pain control. […] One-half of patients with chronic pancreatitis will eventually require surgery, most commonly because of intractable, disabling pain.
#44 Chronic Pancreatitis: Symptoms, Causes, and Treatment
https://patient.info/digestive-health/chronic-pancreatitis-leaflet
Chronic pancreatitis can cause tummy (abdominal) pain, poor digestion, diabetes and other complications. […] The symptoms can vary between cases. The most common symptoms include: […] Tummy (abdominal) pain – just below the ribs is common. The pain is typically felt spreading through to the back. It tends to be persistent and may be partly eased by leaning forward. It may be mild at first but can become severe. Eating often makes the pain worse. This may lead to eating less and then losing weight. The pain can be intermittent – so not present all the time. […] Poor digestion (malabsorption) – occurs if not enough chemicals (enzymes) are made by the damaged pancreas. In particular, the digestion of fats and certain vitamins is affected. Undigested fat from the diet may remain in the gut and be passed with stools (faeces). This causes pale, smelly, loose stools which are difficult to flush away (steatorrhoea). Weight loss can also occur if food is not fully digested.
#45 Chronic Pancreatitis – Harvard Health
https://www.health.harvard.edu/a_to_z/chronic-pancreatitis-a-to-z
Once the cells of the pancreas have been destroyed, they do not regenerate easily. For this reason, diabetes and other problems that are associated with chronic pancreatitis require long-term treatment. It is unclear why pain develops with chronic pancreatitis, but once chronic pain develops, it tends to be long-lasting or even lifelong. Many patients require long-term medications for pain. […] Although chronic pancreatitis is an incurable condition, the severity, frequency, and type of symptoms can vary. Some people especially those who quit drinking alcohol entirely have very mild or occasional symptoms that are easily managed with medications. Other people especially those who continue to drink alcohol can have disabling, daily pain and may require frequent hospitalizations.
#46 Chronic pancreatitis Guide: Causes, Symptoms and Treatment Options
https://www.drugs.com/health-guide/chronic-pancreatitis.html
Although chronic pancreatitis is an incurable condition, the severity, frequency, and type of symptoms can vary. Some people â especially those who quit drinking alcohol entirely â have very mild or occasional symptoms that are easily managed with medications. Other people â especially those who continue to drink alcohol â can have disabling, daily pain and may require frequent hospitalizations.
#47 Chronic Pancreatitis: Symptoms, Causes, and Treatment
https://patient.info/digestive-health/chronic-pancreatitis-leaflet
Diabetes – occurs in about 1 in 3 cases. This occurs when the pancreas cannot make sufficient insulin. Symptoms usually include excess thirst, passing large amounts of urine and further weight loss unless the diabetes is treated. However, chronic pancreatitis is actually an uncommon cause of diabetes – most people with diabetes have developed it for another reason. […] Chronic pancreatitis often becomes worse with time. The time from the initial triggering of inflammation to damage, scarring and calcium stones, and then to developing digestion problems or diabetes, is often several years. However, many months or years of this process can go on before any symptoms are first noticed. […] If you continue to drink alcohol and pancreatitis becomes severe then life expectancy is typically reduced by 10-20 years. This is due to complications of pancreatitis or to other alcohol-related illnesses. If you stop drinking alcohol completely in the early stages of the condition then the outlook is better.
#48 Chronic Pancreatitis: Symptoms, Causes and Treatment | Ada
https://ada.com/conditions/chronic-pancreatitis/
For some people with chronic pancreatitis, the first noticeable symptoms may actually be caused by complications rather than the condition itself. […] If a person has chronic pancreatitis, the pancreas may become so damaged that it cannot produce enough enzymes to absorb nutrients from food. This can lead to a condition called malabsorption, which causes symptoms of weight loss, diarrhea, greasy-looking stools, known as steatorrhea, flatulence. […] If the pancreas is damaged to the extent that it can no longer produce enough insulin, a person with chronic pancreatitis may develop diabetes. […] Chronic pancreatitis increases the risk of developing pancreatic cancer. However, most people with chronic pancreatitis will not develop pancreatic cancer.
#49 Acute Recurrent and Chronic Pancreatitis in Children | Children’s Hospital Los Angeles
https://www.chla.org/pancreatitis
On average, symptoms of acute pancreatitis will last about 3-7 days, and will improve over time. Children with chronic pancreatitis may develop long-term issues. […] With chronic pancreatitis, there is an increased risk of developing pancreatic cancer compared to the general population. The degree of risk depends on the underlying cause of pancreatitis and should be discussed with your doctor.
#50 Acute & Chronic Pancreatitis Symptoms & Treatment | MedStar Health
https://www.medstarhealth.org/services/pancreatitis
Chronic pancreatitis is a long-term condition in which the pancreas has been permanently damaged by past inflammation. This condition causes constant or intermittent pain for years, worsening as time goes on. Patients with chronic pancreatitis have a decreased ability to secrete enzymes that aid digestion and hormones to regulate sugar metabolism. As a result, this is a lifelong condition that will need to be managed. […] People with chronic pancreatitis often lose weight, even when their appetite and eating habits are normal. The weight loss occurs because the body does not secrete enough pancreatic enzymes to digest food, so nutrients are not absorbed normally. Poor digestion leads to malnutrition due to excretion of fat in the stool. As a result, this condition can also cause: […] Patients with chronic pancreatitis will typically need additional treatment and management, such as: Long-term chronic pain management, Enzyme supplements to aid in digestion, Dietary changes, Regular screenings for pancreatic cancer. […] In severe chronic cases (called necrotizing pancreatitis), surgery may be needed to remove dead or infected pancreatic tissue.
#51 Chronic Pancreatitis Explained: From Diagnosis to Treatment
https://www.summithealth.com/health-wellness/chronic-pancreatitis-explained-diagnosis-treatment
Chronic pancreatitis manifests through various symptoms, which can vary in intensity: […] Symptoms: Includes persistent abdominal pain, nausea, vomiting, weight loss, fatty stools (steatorrhea) and diabetes. […] Many individuals with chronic pancreatitis can live for many years with proper management. However, the condition can lead to severe complications that may affect life expectancy, such as pancreatic cancer, diabetes and malnutrition. […] Life expectancy: Varies based on the extent of pancreatic damage, underlying causes and how well the condition is managed. Proper management can lead to a better quality of life. […] Prevention of complications: Annual checkups, regular monitoring and follow-ups with healthcare providers are crucial to manage symptoms and prevent complications like malnutrition, diabetes and pancreatic cancer.