Pancreatitis (cont.)
What are the symptoms of chronic pancreatitis?
Most
people with chronic pancreatitis have abdominal pain, although some people have
no pain at all. The pain may get worse when eating or drinking, spread to the
back, or become constant and disabling. In certain cases, abdominal pain goes
away as the condition advances, probably because the pancreas is no longer
making digestive enzymes. Other symptoms include nausea, vomiting,
weight loss,
and fatty stools.
People with chronic disease 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 break down food, so nutrients are not
absorbed normally. Poor digestion leads to excretion of fat, protein, and sugar
into the stool. If the insulin-producing cells of the pancreas (islet cells)
have been damaged, diabetes may also develop at this stage.
How is chronic pancreatitis diagnosed?
Diagnosis may be difficult, but new techniques can help. Pancreatic
function tests help a doctor decide whether the pancreas is still making enough
digestive enzymes. Using ultrasonic imaging, endoscopic retrograde
cholangiopancreatography (ERCP), and CAT scans, a doctor can see problems
indicating chronic pancreatitis. Such problems include calcification of the
pancreas, in which tissue hardens from deposits of insoluble calcium salts. In
more advanced stages of the disease, when diabetes and malabsorption occur, a
doctor can use a number of blood, urine, and stool tests to help diagnose
chronic pancreatitis and to monitor its progression.
How is chronic pancreatitis treated?
Relieving pain is the first step in treating chronic pancreatitis.
The next step is to plan a diet that is high in carbohydrates and low in fat.
A doctor may prescribe pancreatic enzymes to take with meals if the pancreas
does not secrete enough of its own. The enzymes should be taken with every meal
to help the body digest food and regain some weight. Sometimes insulin or other
drugs are needed to control blood glucose.
In some cases, surgery is needed to relieve pain. The surgery may involve
draining an enlarged pancreatic duct or removing part of the pancreas.
For fewer and milder attacks, people with pancreatitis must stop drinking
alcohol, stick to their prescribed diet, and take the proper medications.
Next: Pancreatitis in children »
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