Chronic Pancreatitis: When Inflammation Becomes Permanent

What is Chronic Pancreatitis?

Chronic pancreatitis is a long-term, progressive inflammation of the pancreas. Unlike acute attacks, the damage is irreversible.

Over time, the pancreas becomes scarred and loses its ability to make enzymes and insulin — leading to digestive problems and diabetes.

Causes

• Alcohol abuse (most common in adults)

• Genetic mutations (PRSS1, SPINK1, CFTR)

• Smoking

• Autoimmune pancreatitis

• Obstructive causes (strictures, tumors)

• Idiopathic (unknown)

Symptoms

• Persistent/recurrent upper abdominal pain (radiates to back)

• Indigestion, bloating, diarrhea

• Steatorrhea (oily, foul-smelling stools)

• Unexplained weight loss

• Diabetes in later stages

Diagnosis

• CT, MRI, MRCP: Show scarring, duct dilation, calcifications

• Endoscopic ultrasound (EUS): Detects early fibrosis

• Stool elastase test: Measures enzyme deficiency

• Blood sugar tests: Screen for diabetes

Treatment

There is no cure, but management includes:

• No alcohol, no smoking

• Pancreatic enzyme supplements (PERT)

• Pain management (medications, nerve blocks, surgery)

• Nutritional support (high-protein, low-fat diet, vitamins)

• Diabetes management (insulin or oral agents)

Complications

• Severe malnutrition

• Osteoporosis

• Chronic pain and opioid dependence

• Pancreatic cancer risk