Chronic pancreatitis

DEFINITION

Chronic pancreatitis is a chronic inflammation of the pancreas.

CAUSE

In the United States, the most common cause of chronic pancreatitis is alcoholism.

Other causes are hereditary factors and pancreatic duct obstruction caused by the narrowing of the channel or pancreatic cancer.

Acute pancreatitis rarely causes a narrowing of the pancreatic duct that will lead to the occurrence of chronic pancreatitis.
In many cases, the cause of chronic pancreatitis is unknown.

In tropical countries (Indonesia, India, Nigeria), chronic pancreatitis with unknown cause that occurs in children and young adults, can lead to diabetes and the buildup of calcium in the pancreas.

Initial symptoms generally come from diabetes.


SYMPTOMS

Symptoms of chronic pancreatitis are generally divided into two patterns .

The first , the patient experienced abdominal pain that persisted middle , which weighs varied .

Secondly , the patient experienced intermittent episodes of pancreatitis , with symptoms similar to a mild to moderate acute pancreatitis . The pain is sometimes severe and last for several hours or several days .

In the second pattern , in line with the development of the disease , the cells that produce digestive enzymes , are slowly damaged , so that eventually the pain does not arise .

By decreasing the amount of digestive enzymes , the food is not absorbed optimally , and people will spend a lot of stools and foul smelling . Can be light-colored stool and oily and can even contain oil droplets .

Impaired absorption also causes weight loss .

At the end of the insulin-producing cells may be damaged and will gradually lead to diabetes (diabetes ) .


Diagnosis

Diagnosis based on symptoms or a history of acute pancreatitis .

A blood test is less useful in diagnosing chronic pancreatitis , but may show elevated levels of amylase and lipase .

Blood tests can also be used to determine blood sugar levels , which may be increased .

Abdominal x-rays and ultrasound may show a stone in the pancreas .

Endoscopic retrograde pankreatografi ( X-ray technique that shows the structure of the pancreatic duct ) could show that the channel widening , narrowing the channel or duct stones .

CT scans can show a change in the size , shape and texture of the pancreas .

TREATMENT

During an attack , which is very important is to avoid alcohol .

Avoid all foods and only receive intravenous fluids , resting the pancreas and intestines can also reduce pain .

But narcotic pain reliever , is still often necessary to relieve pain .

To mitigate the attack , it is recommended to eat 4-5 times / day , which contains less fat and protein , and lots of carbohydrates .
Alcohol should still be avoided .

If pain persists , is likely to have complications , such as inflammation of the future head of the pancreas or a pseudocyst .
The period of inflammation require surgical treatment .

Pseudocyst which causes pain in line with its development , may have to undergo decompression ( pressure reduction ) .

If patients continue to feel pain and no complications , doctors usually inject pain inhibitory nerves to the pancreas so that arousal does not get to the brain .

If this fails , surgery may be required .

If the dilated pancreatic duct , pancreas manufacture of a shortcut to the small intestine , to reduce pain in approximately 70-80 % of patients .

If the channel is not widened , a portion of the pancreas may be removed.

When the head of the pancreas is affected, this section removed along with the duodenum . This surgery can reduce pain in 60-80 % of patients .

In alcoholics who experience healing , partial removal of the pancreas performed only on those who can cope with diabetes will occur after surgery .

By taking tablets or capsules containing extracts of pancreatic enzymes at mealtime , can make the stools become less fat and improve the absorption of food , but this is rarely the problem can be resolved .

If necessary , a solution of antacids or H2 inhibitors can be taken together with pancreatic enzymes .

With such treatment , the patient's weight will usually increase , the amount of waste water becomes more scarce , no longer contained oil droplets in the stool and in general will feel better .

If the above treatment is not effective , the patient may try to reduce fat intake .

Maybe also needed additional fat-soluble vitamins ( vitamins A , D , E and K ) .