The pancreas is an organ in the abdomen. The pancreas is an organ that makes certain juices that help break down food and is also responsible for producing certain hormones, including insulin, which is responsible for regulating one’s blood sugar. Pancreatitis is the term doctors and nurses use when this organ gets irritated or swollen. Most people get over pancreatitis without any long-lasting effects. But a few people get very sick. Chronic pancreatitis occurs when the pancreas becomes damaged by long-standing inflammation. Inflammation changes the pancreas’ ability to function normally. People with chronic pancreatitis require ongoing medical care to minimise their symptoms, slow the damage to the pancreas, and address any complications that arise. In most cases, treatment controls but does not cure the underlying problem. There are many causes of pancreatitis. But most cases are caused by gallstones or alcohol abuse. People who drink too much alcohol for too long sometimes get alcohol-related pancreatitis. People with this form of pancreatitis usually start to feel pain one to three days after drinking a lot of alcohol or after they suddenly stop drinking. They usually also have nausea and vomiting. People with this form of pancreatitis must learn to give up alcohol to keep from getting pancreatitis again. Gallstones are hard lumps that form inside an organ called the gallbladder. Both the pancreas and the gallbladder drain into a single tube. If that tube gets clogged by a gallstone, neither of the organs can drain. When that happens, the fluids from both organs get backed up. That can cause pain. The most common symptom of chronic pancreatitis is long-standing pain in the middle of the abdomen. You may also have episodes when the pancreas suddenly becomes inflamed and your pain suddenly worsens (called acute pancreatitis). Abdominal pain usually occurs in the upper abdomen, often spreads to the back, may be relieved by sitting up or leaning forward, and may be associated with nausea and vomiting. The pain is often worse 15 to 30 minutes after a meal. However, about 20 per cent of people with chronic pancreatitis do not have any pain at all. The pancreas normally helps to digest foods and control blood sugar levels. In people with chronic pancreatitis, the pancreas may not function normally, leading to difficulty processing fat in the diet. This can cause loose, greasy, foul-smelling stools that are difficult to flush. This can lead to vitamin and nutrient deficiencies, including weight loss. These symptoms do not usually develop until the pancreas loses about 90 per cent of its function. It can be difficult to diagnose chronic pancreatitis; the signs and symptoms can be similar to those caused by other health problems, such as an ulcer, gallstones, and many others. Tests may be normal, especially during the first two to three years of the condition. It can also be difficult to distinguish chronic pancreatitis from acute pancreatitis. There are a few blood tests that can help the physician to figure out if one has pancreatitis. It’s also possible that a special kind of x-ray called a “CT scan” or MRI and other radiology investigations of the abdomen be ordered to check if belly pain is due to pancreatitis or other conditions. Some of the tests for chronic pancreatitis can help to determine the likelihood of having pancreatic cancer. These tests may be done because the signs of chronic pancreatitis and pancreatic cancer are similar. Treatment of chronic pancreatitis can help to relieve pain, improve pancreatic function, and manage complications. A variety of measures can help relieve the pain of chronic pancreatitis. Simple measures may be sufficient early in the course of the condition, whereas more extensive measures may be needed after several years. Avoiding alcohol is the single MOST important treatment for people with pancreatitis related to alcohol abuse. Avoiding alcohol can also improve pain and reduce the risk of acute pancreatitis as well as the risk of dying. The pain of chronic pancreatitis may be reduced by eating small, low-fat meals and drinking enough fluids. Many other different treatments can be prescribed by one’s doctor depending on the individual’s bothersome symptoms and severity of their condition. Dr. Ian Shyaka Resident in Surgery,Rwanda Military Hospital, iangashugi@gmail.com
