Chronic Pancreatitis

Chronic pancreatitis is a prolonged inflammation of the pancreas which leads to fibrosis, atrophy and ultimately functional loss of the pancreas. This happens due to depleting cells of pancreas. Also due to chronic inflammation there is formation of stones in the pancreatic duct, therefore also known as pancreatic stone disease.

Risk factors

• Alcohol intake
• Smoking
• Recurrent pancreatitis
• Hypercalcemia
• Hypertriglyceridemia
• Genetic

A patient of chronic pancreatitis can have

• Digestion problems:
  fat indigestion—>foul smelling, bulky, oily stools known as Steatorrhea.
  Protein indigestion: bloating
• Diabetes: when insulin cells deplete in number. Usually a late phenomenon.
• Pain in the upper abdomen usually after food. It radiates to the back and may be associated with vomiting
• Sometimes vomiting if there is gastric outlet obstruction
• Bleeding
• Unwanted weight loss

The disease is usually diagnosed on an imaging modality like CT Scan, an Ultrasound or an MRI which would show atrophy of pancreas with dilated pancreatic duct with calculi in it.

The other tests like fecal fat content. Certain invasive tests, are also there but they are not usually required.

The treatment involves

Medical Management: with pancreatic enzymes supplementation, PPIs, and insulin for diabetes and pain killers for pain

SURGERY FOR CHRONIC PANCREATITIS
The main aim of the surgery is to relieve the pain. It is important to understand that it does not alter the disease course but only relieves pain.

The surgery can be in form of opening the duct and removing it the stones and joining small intestine to the duct for drainage.

Or it can be removal of a part of the pancreatic parenchyma.

Complications of Chronic Pancreatitis:

• Jaundice
• Gastric outlet obstruction
• Portal hypertension with hematemesis
• Rarely cancer formation

Please visit your best GI surgeon in Delhi for the treatment at the earliest.