Chronic Pancreatitis is a long-term inflammation of pancreas causes irreversible damage to structure and function.
Chronic inflammation may result in abdominal pain and impaired pancreatic functions.Pancreatitis causes loss of enzyme production and hormonal issues.
Acute pancreatitis patients recover fully, while chronic pancreatitis shows irreversible chronic inflammation with fibrosis and calcification.
Chronic pancreatitis shows abdominal pain with normal/mildly high pancreatic enzymes. Loss of pancreas function leads to diabetes and steatorrhea.
The pancreas is a glandular organ located behind the stomach. Exocrine function creates digestive enzymes to break down nutrients in intestines.
Endocrine function regulates blood sugar with insulin and glucagon hormones.
Epidemiology
Approximately 87,000 annual pancreatitis cases occur in the United States while global hospital admissions data show similar frequency.
Hospitalization rates is 3 times higher for black people in US, but males are more affected in studies.
Hospitalization rates for chronic pancreatitis differ as per sex. Rates for male’s peak at 45 to 54 years old and decline, while female rates plateau after 35 years old.
Alcohol-induced illness is more common in males, while idiopathic and hyperlipidemic-induced pancreatitis is more common in females.
Anatomy
Pathophysiology
Injury triggers pancreatic fibrogenesis through growth factors, cytokines, and chemokines. This result occurs in extracellular matrix deposition and fibroblast proliferation.
TGF-beta from pancreatic injury enhances growth of mesenchymal cells in the area. Pancreas loses ability to secrete enzymes and bicarbonate due to fibrosis in acini and ducts.
Alcohol and toxins cause oxidative stress, inflammation, and cell damage. Reactive oxygen in pancreas activates stellate cells.
Etiology
The causes of chronic pancreatitis are:
Alcohol Abuse
Genetic Factors
Gallstones
Autoimmune Pancreatitis
Hypercalcemia and Hypertriglyceridemia
Genetics
Prognostic Factors
Chronic pancreatitis patients have a 70% at 10-year and a 45% at 20-year survival rate. An international study found a standard mortality ratio of 3.6.
Pseudocyst forms from pancreatic juice surrounded with fibrous tissue due to acute, chronic pancreatitis or trauma.
Pseudocysts in various sizes, numbers, and locations, some outside the pancreas and connect to the pancreatic ductal system with digestive enzymes.
Diabetes and malnutrition in patients can be improved with early diagnosis and lifestyle changes.
Clinical History
Collect details including pain, acute episodes, and medical history to understand clinical history of patient.
Physical Examination
Abdominal Examination
Liver Examination
Pulmonary Examination
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Chronic symptoms are:
Recurrent or persistent abdominal pain, Malabsorption, Diabetes
Acute symptoms are:
Severe epigastric pain, Nausea and vomiting, Tenderness on palpation of the upper abdomen
Differential Diagnoses
Cholangitis
Acute Cholecystitis
Chronic Gastritis
Pancreatic Cancer
Crohn Disease
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
Patients with mild pancreatitis receive IV fluids and pain medication continue fasting until symptoms improve.
Patients with malnutrition or inability to take oral meds after long hospital stay should receive nutritional supplements.
Severe pancreatitis may lead to critical illness in recurrent or chronic cases.
Pancreatic duct blockage from strictures or stones leads to increased pressure and pain. Ischemia from compartment syndrome causes pain relieved to decompress the duct.
Use external enzymes may reduce pancreas-induced pain from food, based on their stimulation hypothesis.
For severe, intractable pain unresponsive to conventional treatment, consider celiac ganglion blockade to modify afferent sensory nerves.
Interventional proceduresinclude Endoscopic Retrograde Cholangiopancreatography, Percutaneous Drainage of Pancreatic Pseudocysts, and Celiac Plexus Block.
use-of-phases-in-managing-chronic-pancreatitis
In initial treatment phase, evaluation of history, physical examination and endoscopy test to confirm diagnosis.
Pharmacologic therapy is effective in the treatment phase as it includes use of analgesics, Nonsteroidal Anti-Inflammatory Drugs, hormones, and antidepressants.
In supportive care and management phase, patients should receive required attention such as lifestyle modification and surgical intervention.
The regular follow-up visits with the gastroenterologist are scheduled to check the improvement of patients along with treatment response.
Chronic Pancreatitis is a long-term inflammation of pancreas causes irreversible damage to structure and function.
Chronic inflammation may result in abdominal pain and impaired pancreatic functions.Pancreatitis causes loss of enzyme production and hormonal issues.
Acute pancreatitis patients recover fully, while chronic pancreatitis shows irreversible chronic inflammation with fibrosis and calcification.
Chronic pancreatitis shows abdominal pain with normal/mildly high pancreatic enzymes. Loss of pancreas function leads to diabetes and steatorrhea.
The pancreas is a glandular organ located behind the stomach. Exocrine function creates digestive enzymes to break down nutrients in intestines.
Endocrine function regulates blood sugar with insulin and glucagon hormones.
Approximately 87,000 annual pancreatitis cases occur in the United States while global hospital admissions data show similar frequency.
Hospitalization rates is 3 times higher for black people in US, but males are more affected in studies.
Hospitalization rates for chronic pancreatitis differ as per sex. Rates for male’s peak at 45 to 54 years old and decline, while female rates plateau after 35 years old.
Alcohol-induced illness is more common in males, while idiopathic and hyperlipidemic-induced pancreatitis is more common in females.
Injury triggers pancreatic fibrogenesis through growth factors, cytokines, and chemokines. This result occurs in extracellular matrix deposition and fibroblast proliferation.
TGF-beta from pancreatic injury enhances growth of mesenchymal cells in the area. Pancreas loses ability to secrete enzymes and bicarbonate due to fibrosis in acini and ducts.
Alcohol and toxins cause oxidative stress, inflammation, and cell damage. Reactive oxygen in pancreas activates stellate cells.
The causes of chronic pancreatitis are:
Alcohol Abuse
Genetic Factors
Gallstones
Autoimmune Pancreatitis
Hypercalcemia and Hypertriglyceridemia
Chronic pancreatitis patients have a 70% at 10-year and a 45% at 20-year survival rate. An international study found a standard mortality ratio of 3.6.
Pseudocyst forms from pancreatic juice surrounded with fibrous tissue due to acute, chronic pancreatitis or trauma.
Pseudocysts in various sizes, numbers, and locations, some outside the pancreas and connect to the pancreatic ductal system with digestive enzymes.
Diabetes and malnutrition in patients can be improved with early diagnosis and lifestyle changes.
Collect details including pain, acute episodes, and medical history to understand clinical history of patient.
Abdominal Examination
Liver Examination
Pulmonary Examination
Chronic symptoms are:
Recurrent or persistent abdominal pain, Malabsorption, Diabetes
Acute symptoms are:
Severe epigastric pain, Nausea and vomiting, Tenderness on palpation of the upper abdomen
Cholangitis
Acute Cholecystitis
Chronic Gastritis
Pancreatic Cancer
Crohn Disease
Patients with mild pancreatitis receive IV fluids and pain medication continue fasting until symptoms improve.
Patients with malnutrition or inability to take oral meds after long hospital stay should receive nutritional supplements.
Severe pancreatitis may lead to critical illness in recurrent or chronic cases.
Pancreatic duct blockage from strictures or stones leads to increased pressure and pain. Ischemia from compartment syndrome causes pain relieved to decompress the duct.
Use external enzymes may reduce pancreas-induced pain from food, based on their stimulation hypothesis.
For severe, intractable pain unresponsive to conventional treatment, consider celiac ganglion blockade to modify afferent sensory nerves.
Gastroenterology
Proper nutrition has great importance in pancreatitis patients, particularly those who are undergoing the treatment.
Alternative pain management approaches like relaxation therapy, acupuncture, and massage can help patient to feel less pain.
Physical activity and exercise can be a good way to improve the strength, endurance and overall wellness of the patients.
Proper awareness about chronic pancreatitis should be provided and its related causes with management strategies.
Appointments with a gastroenterologist and preventing recurrence of disorder is an ongoing life-long effort.
It is non-enteric coated product used to treat pancreatitis pain with a proton pump inhibitor.
Gastroenterology
Interventional proceduresinclude Endoscopic Retrograde Cholangiopancreatography, Percutaneous Drainage of Pancreatic Pseudocysts, and Celiac Plexus Block.
Gastroenterology
In initial treatment phase, evaluation of history, physical examination and endoscopy test to confirm diagnosis.
Pharmacologic therapy is effective in the treatment phase as it includes use of analgesics, Nonsteroidal Anti-Inflammatory Drugs, hormones, and antidepressants.
In supportive care and management phase, patients should receive required attention such as lifestyle modification and surgical intervention.
The regular follow-up visits with the gastroenterologist are scheduled to check the improvement of patients along with treatment response.
Chronic Pancreatitis is a long-term inflammation of pancreas causes irreversible damage to structure and function.
Chronic inflammation may result in abdominal pain and impaired pancreatic functions.Pancreatitis causes loss of enzyme production and hormonal issues.
Acute pancreatitis patients recover fully, while chronic pancreatitis shows irreversible chronic inflammation with fibrosis and calcification.
Chronic pancreatitis shows abdominal pain with normal/mildly high pancreatic enzymes. Loss of pancreas function leads to diabetes and steatorrhea.
The pancreas is a glandular organ located behind the stomach. Exocrine function creates digestive enzymes to break down nutrients in intestines.
Endocrine function regulates blood sugar with insulin and glucagon hormones.
Approximately 87,000 annual pancreatitis cases occur in the United States while global hospital admissions data show similar frequency.
Hospitalization rates is 3 times higher for black people in US, but males are more affected in studies.
Hospitalization rates for chronic pancreatitis differ as per sex. Rates for male’s peak at 45 to 54 years old and decline, while female rates plateau after 35 years old.
Alcohol-induced illness is more common in males, while idiopathic and hyperlipidemic-induced pancreatitis is more common in females.
Injury triggers pancreatic fibrogenesis through growth factors, cytokines, and chemokines. This result occurs in extracellular matrix deposition and fibroblast proliferation.
TGF-beta from pancreatic injury enhances growth of mesenchymal cells in the area. Pancreas loses ability to secrete enzymes and bicarbonate due to fibrosis in acini and ducts.
Alcohol and toxins cause oxidative stress, inflammation, and cell damage. Reactive oxygen in pancreas activates stellate cells.
The causes of chronic pancreatitis are:
Alcohol Abuse
Genetic Factors
Gallstones
Autoimmune Pancreatitis
Hypercalcemia and Hypertriglyceridemia
Chronic pancreatitis patients have a 70% at 10-year and a 45% at 20-year survival rate. An international study found a standard mortality ratio of 3.6.
Pseudocyst forms from pancreatic juice surrounded with fibrous tissue due to acute, chronic pancreatitis or trauma.
Pseudocysts in various sizes, numbers, and locations, some outside the pancreas and connect to the pancreatic ductal system with digestive enzymes.
Diabetes and malnutrition in patients can be improved with early diagnosis and lifestyle changes.
Collect details including pain, acute episodes, and medical history to understand clinical history of patient.
Abdominal Examination
Liver Examination
Pulmonary Examination
Chronic symptoms are:
Recurrent or persistent abdominal pain, Malabsorption, Diabetes
Acute symptoms are:
Severe epigastric pain, Nausea and vomiting, Tenderness on palpation of the upper abdomen
Cholangitis
Acute Cholecystitis
Chronic Gastritis
Pancreatic Cancer
Crohn Disease
Patients with mild pancreatitis receive IV fluids and pain medication continue fasting until symptoms improve.
Patients with malnutrition or inability to take oral meds after long hospital stay should receive nutritional supplements.
Severe pancreatitis may lead to critical illness in recurrent or chronic cases.
Pancreatic duct blockage from strictures or stones leads to increased pressure and pain. Ischemia from compartment syndrome causes pain relieved to decompress the duct.
Use external enzymes may reduce pancreas-induced pain from food, based on their stimulation hypothesis.
For severe, intractable pain unresponsive to conventional treatment, consider celiac ganglion blockade to modify afferent sensory nerves.
Gastroenterology
Proper nutrition has great importance in pancreatitis patients, particularly those who are undergoing the treatment.
Alternative pain management approaches like relaxation therapy, acupuncture, and massage can help patient to feel less pain.
Physical activity and exercise can be a good way to improve the strength, endurance and overall wellness of the patients.
Proper awareness about chronic pancreatitis should be provided and its related causes with management strategies.
Appointments with a gastroenterologist and preventing recurrence of disorder is an ongoing life-long effort.
It is non-enteric coated product used to treat pancreatitis pain with a proton pump inhibitor.
Gastroenterology
Interventional proceduresinclude Endoscopic Retrograde Cholangiopancreatography, Percutaneous Drainage of Pancreatic Pseudocysts, and Celiac Plexus Block.
Gastroenterology
In initial treatment phase, evaluation of history, physical examination and endoscopy test to confirm diagnosis.
Pharmacologic therapy is effective in the treatment phase as it includes use of analgesics, Nonsteroidal Anti-Inflammatory Drugs, hormones, and antidepressants.
In supportive care and management phase, patients should receive required attention such as lifestyle modification and surgical intervention.
The regular follow-up visits with the gastroenterologist are scheduled to check the improvement of patients along with treatment response.
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