Chronic pancreatitis

Maladies digestives
La pancréatite chronique
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Continuation of the text on: Acute pancreatitis

Chronic pancreatitis is one of the two types of pancreatitis along with acute pancreatitis. According to the Canadian Digestive Health Foundation (CDHF), more than 300,000 Canadians are affected by it. Let's learn more about this chronic disease.

Definition of chronic pancreatitis

Chronic pancreatitis is a digestive disorder affecting the pancreas, an organ located in the upper part of the abdomen that produces insulin and digestive enzymes. It is characterized by ongoing inflammation of the pancreas leading to permanent structural and functional damage.

Causes of chronic pancreatitis

Two major causes of chronic pancreatitis are excessive alcohol consumption and smoking. Less commonly, certain genetic disorders and obstruction due to stones or cancer can also cause chronic pancreatitis. Finally, in many cases, this disease has no obvious cause.

Symptoms of chronic pancreatitis

One of the main symptoms of chronic pancreatitis is abdominal pain. Another major symptom of chronic pancreatitis is pancreatic insufficiency. It is characterized by a decrease in pancreatic enzymes involved in food digestion. Consequently, this leads to malabsorption of food which can result in malnutrition and weight loss. Malabsorption is characterized by steatorrhea, fatty stools, and can cause deficiencies in fat-soluble vitamins including vitamins A, D, E, and K. Finally, as chronic pancreatitis progresses, the insulin-secreting cells can be destroyed which may lead to diabetes.

Diagnosis of chronic pancreatitis

The diagnosis of chronic pancreatitis is based on the clinical picture (symptoms, alcohol consumption, history of recurrent acute pancreatitis, etc.), imaging (e.g., X-ray, CT scan, etc.), and pancreatic function tests. These tests determine if the pancreas is functioning properly and if pancreatic insufficiency causing malabsorption is present.

Treatment of chronic pancreatitis

Medical treatment of chronic pancreatitis involves pain control, pancreatic enzyme supplementation, as well as management of diabetes and other complications of the disease.

Nutritional approach for chronic pancreatitis

In the case of chronic pancreatitis, the nutritional approach aims to maintain or restore nutritional status, reduce pain, and prevent further pancreatic damage by decreasing its stimulation.

  • First, it is recommended for all individuals suffering from chronic pancreatitis to stop consuming alcohol and tobacco to slow the progression of the disease.
  • Second, it is also recommended to follow a low-fat diet divided into several small daily meals. A low-fat diet can help reduce pancreatic enzyme secretion and decrease pain. It can also help reduce steatorrhea in cases of malabsorption.
  • Third, in cases of pancreatic insufficiency, taking pancreatic enzymes with meals can help reduce steatorrhea and promote food absorption. If symptoms persist despite these measures, medium-chain triglycerides (MCTs) can be used as a source of lipids because their absorption does not depend on pancreatic enzymes. Finally, supplementation with fat-soluble vitamins (A, D, E, and K) may sometimes be required.

Finally, nutritional support may sometimes be necessary for some individuals to meet their needs.

References

Article written by:

Marie-Noël Marsan, written in 2021.

 

 

Tags: Maladies digestives

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