Chronic pancreatitis (Chronic pancreatitis)

Definition and causes

Chronic pancreatitis is a persistent inflammation, occurred in the pancreas, with varying degrees of vævsbeskadigelse to follow. Glands tissue is destroyed, and its production of digestive enzymes for digestion of food in the intestine, and important hormones like insulin, reduced gradually. The mode can develop slowly over several years before the symptoms, but can also occur after one or more cases of acute pancreatitis.

The disease is relatively rare. It almost never seen in children (except for children suffering from cystic fibrosis) but debuterer most in 40 to 45 years of age. The incidence is more than twice as high among men as among women.

The overriding cause of chronic pancreatitis issignificantlyalcoholfor some years. In addition, it is felt that the disease can be seen as an extension of the disease mechanism of acute pancreatitis, and therefore have multiple causes with this. Ble.gallstoneshigh-fat (triglycerides) In the blood, increased calcium content (calcium) In the blood, and some hereditary conditions. However, some are only suspected causes and probably covers only a few percent of cases.

Previously, a frequent cause of gallstones, but today rarely cause gallstones chronic disease of the pancreas (probably due to more aggressive treatment of gallstones). In 25-30% of cases are the cause of chronic pancreatitis not.

Symptoms of chronic pancreatitis

The mode can be in the early phase have few or no symptoms. Over time worsens the condition and symptoms. Frequently seen:

Abdominal pain. The first and the overwhelming symptom. These are often violent and usually present especially after meals (each experiencing constant pain). They are usually located opadtil in the abdomen or under the left rib edge, but can also spread to the entire abdomen. Often labeled radiating to the back. Some will never pain.
Weight loss.
Diarrheaand / orfedtholdig stools (steatoré).Decreased production of enzymes from the pancreas makes the fat in the diet is not sufficiently absorbed in the intestine and is excreted in faeces, which become fat and liquid.

Diagnosis

The diagnosis can be difficult to make. There are various blood tests, which can support the suspicion of pancreatitis, and in some cases, you can certainly make the diagnosis after an X-ray - or ultrasound study showing calcification of glands. Before Monday frequently used a kikkertundersøgelse (ERCP) for diagnostic assessment, but because of discomfort and complications are gradually moved to a special MRI called MRCP.

These methods are not always enough. You can also undertake a study of the pancreas production of digestive enzymes and hormones (test for diabetes due to insulin deficiency). These may show reduced function of the glands, which gives suspicion of chronic pancreatitis, especially if there has been a high alcohol consumption and symptoms such as abdominal pain.

Treatment of chronic pancreatitis

The treatment goes on three things. Treatment ofcauses, Treatment ofcomplications(see below) and treatment ofsymptoms. The treatment can not remedy the damage may have already been done, but in some cases, dampen the inflammatory response and thus slow down or stop further vævsbeskadigelse and complication development.

Cause Treatment
If the cause is alcohol, the total abstinence probably stop development of the disease and often reduce the pain considerably. Increased calcium or fats in the blood may also be treated with good effect. If the cause is gallstones, they can be operated and removed the gallbladder removed, the impact of this illness is not resolved.

Complication Treatment
Possible complications (described below) treated as far as possible. Cyst puncture and discharged with a needle and clog calcification in glands system away once operated. Enzyme shortage treated with a diet and possible. enzyme grants in tablet form. Decreased insulin production is treated as diabetes, moreover, however, it is often necessary to give insulin, and dealt instead with diet and medication as in type 2 diabetes.

Symptomatic treatment
Symptom The treatment focuses attention on pain coverage. It is often necessary to use morphine or similar strong preparations. We have tried to relieve pain through various surgical and example. remove parts of the damaged gland. The effect is varied.

Select and complications

The course of chronic pancreatitis is very variable. There is everything from the mild scenario, almost without symptoms and with only slight impact on the glands function, to very painful process of several years, with many complications and possible. total function defect of the pancreas.

Illness Consequences and complications of the disease include:

Operating losses of the pancreasoccurs as mentioned gradually and causes reduced production of digestive enzymes necessary for the intestine. This can lead to impaired nutrient absorption (malabsorption). Pancreas also produces the key hormone insulin, and reduced production could lead todiabetes.
Calcification of the pancreas, Which occurred more frequently the longer the disease has persisted. These can block the transmission system of glands and give pain.
Cysts(fluid-filled blisters)can occur in the pancreas and worsen stomach pain.
Ulcercan occur in the gut (duodenal ulcer), when pancreassaften no longer produced in sufficient quantities to neutralize stomach acid.
Blocking biliary tractcan occur when the pancreas and biliary tract from the liver is common expiration of the intestine. Inflammatory reaction in rare cases closing of the bile and give jaundice.
Increased risk ofcancer. People with chronic pancreatitis is of unknown cause generally increased incidence of cancer.

Chronic pancreatitis is a serious disease and often fatal within several years. However, many live long with a mild illness image and functioning normally on a daily basis.

This article is formed on the Health Guide on 30.11.06