Chronic pancreatitis

Overview

Chronic pancreatitis is a long-term inflammation of the pancreas that gets worse over time. The pancreas is a gland behind your stomach that helps digest food and makes insulin to control blood sugar. This condition can cause permanent damage, leading to pain and problems with digestion.

Chronic pancreatitis is not very common. It affects about 50 out of every 100,000 people. However, it can have a big impact on daily life.

It most often affects adults between 30 and 50 years old. It is more common in men than in women. People who drink a lot of alcohol or smoke are at higher risk.

Symptoms

Common symptoms

• Upper abdominal pain that may spread to your back
• Pain that gets worse after eating, especially fatty meals
• Oily, smelly stools (called steatorrhea) that float and are hard to flush
• Unintended weight loss
• Nausea and vomiting
• Feeling bloated or full quickly

Symptoms in children

• Abdominal pain that may be vague or hard to describe
• Failure to gain weight or grow (failure to thrive)
• Oily stools
• Frequent upset stomach

Symptoms in older adults

• Less intense pain, but more digestive problems
• Unintended weight loss
• New or worsening diabetes
• Weakness and fatigue

Causes

Main causes

• Long-term heavy alcohol use (the most common cause)
• Genetic conditions, such as cystic fibrosis
• Autoimmune disease, where the body attacks its own pancreas
• Blockage of the pancreatic duct due to things like gallstones or tumors
• Sometimes the cause is unknown (called idiopathic)

Risk factors

• Drinking a lot of alcohol over many years
• Smoking tobacco
• Having a family history of pancreatitis or cystic fibrosis
• Certain medications (talk to your doctor)
• High levels of triglycerides or calcium in the blood

When to see a doctor

See a doctor urgently if:

• If you have severe abdominal pain that does not go away
• If you notice jaundice (yellow skin or eyes)
• If you have a high fever with abdominal pain
• If you are vomiting and cannot keep fluids down

Book a routine appointment if:

• If you have ongoing abdominal pain that bothers you
• If you are losing weight without trying
• If you notice oily stools that are difficult to flush
• If you have been diagnosed with diabetes and the cause is unclear

Diagnosis

Your doctor will take a detailed history, do a physical exam, and order tests to look at your pancreas and how it is working. The diagnosis often involves a combination of blood tests, imaging, and sometimes a stool test.

Tests that may be done

• Blood tests to check levels of pancreatic enzymes (amylase, lipase) and liver function
• Imaging tests such as ultrasound, CT scan, or MRI to see the structure of your pancreas
• Endoscopic ultrasound (EUS) to get detailed images and sometimes take a small tissue sample
• Stool tests to measure how much fat is in your stool (an indicator of digestion problems)
• A test called MRCP (magnetic resonance cholangiopancreatography) to look at the ducts
• Sometimes a genetic test to look for inherited causes

What to expect at your appointment

Diagnosis may take several appointments. You will likely need to fast before some tests. The process can feel lengthy, but it helps your doctor understand exactly what is happening so they can recommend the best care.

Treatment

Treatment for chronic pancreatitis focuses on relieving pain, improving digestion, and managing complications. It is a team effort that may involve diet changes, medication, and sometimes procedures. The goal is to help you feel better and maintain a good quality of life.

Self-care at home

• Stop drinking alcohol completely
• Quit smoking (your doctor can help with this)
• Eat small, low-fat meals throughout the day
• Take digestive enzyme supplements with meals as prescribed
• Stay hydrated by drinking plenty of water
• Talk to your doctor before taking any over-the-counter medicines or supplements

Medical treatments

Your doctor may prescribe pain relievers, digestive enzymes to help you absorb nutrients, and vitamins to prevent deficiencies. If you develop diabetes, insulin or other diabetes medicines may be needed. In some cases, doctors may use procedures to relieve blockages or pain, such as endoscopic treatments. Always talk to your doctor about the best options for you.

When is surgery considered?

Surgery may be considered if pain is severe and not controlled with other treatments, or if there is a blockage in the pancreatic duct that cannot be fixed with an endoscope. A common procedure is called a Puestow procedure or resection. Your specialist will discuss the risks and benefits with you.

Living with this condition

Living with chronic pancreatitis means managing pain and adjusting your diet. You may need to take enzymes with every meal and snack. Regular follow-up with your doctor is important to monitor for complications like diabetes.

Lifestyle tips

• Avoid alcohol completely
• Do not smoke or use tobacco in any form
• Maintain a healthy weight with a low-fat diet
• Stay active with gentle exercise like walking or stretching
• Take all medications and supplements exactly as directed

Diet and exercise

Eat small, frequent meals that are low in fat. Focus on fruits, vegetables, whole grains, and lean proteins like chicken or fish. Avoid fried foods, fatty meats, and full-fat dairy. Gentle exercise such as walking, yoga, or swimming can help with pain and mood. Always check with your doctor before starting a new exercise program.

Mental health and emotional wellbeing

Living with chronic pain and dietary restrictions can be stressful and may lead to depression or anxiety. It is normal to feel frustrated or sad. Talk to your doctor about how you are feeling – they can refer you to a counselor or support group. Your emotional health is just as important as your physical health.

Prevention

Not all cases can be prevented, but you can lower your risk by limiting alcohol, not smoking, eating a healthy diet, and maintaining a healthy weight. If you have a family history, talk to your doctor about testing.

Screening programmes

There is no routine screening for chronic pancreatitis. However, if you have a strong family history or known genetic risk, your doctor may suggest monitoring.

Complications

If left untreated

• Diabetes (if the insulin-making cells are damaged)
• Malnutrition and weight loss from not absorbing nutrients properly
• Pancreatic pseudocysts (fluid-filled sacs that can become infected or cause pain)
• Inflammation of other organs
• Increased risk of pancreatic cancer

Long-term outlook

Chronic pancreatitis is a long-term condition, but with proper treatment and lifestyle changes, many people can manage their symptoms and enjoy a good quality of life. Work closely with your healthcare team to stay on top of your health. Early and consistent care makes a real difference.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.