La pancréatite chronique

Continuation of the text on:Acute pancreatitis

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

Definition of chronic pancreatitis

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

Causes of chronic pancreatitis

Two important causes of chronic pancreatitis are excessive alcohol consumption and smoking. More rarely, certain genetic disorders and an obstruction due to stones or cancer can also be the cause of 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 pain in the abdomen. The other major symptom of chronic pancreatitis is pancreatic insufficiency. It is characterized by a decrease in pancreatic enzymes which are involved in the digestion of food. Consequently, it leads to malabsorption of food which can lead to undernutrition and weight loss. Malabsorption is characterized by steatorrhea, fatty stools, and can lead to deficiencies in fat-soluble vitamins including vitamins A, D, E and K. Finally, as chronic pancreatitis progresses, cells secrete insulin can be destroyed which can lead todiabetes.

Diagnosis of chronic pancreatitis

The diagnosis of chronic pancreatitis is based on the clinical portrait (symptoms, alcohol consumption, history of recurrent acute pancreatitis, etc.), imaging (eg: x-ray, computed tomography, etc.) and function tests. pancreatic. These help determine whether the pancreas is functioning properly and whether pancreatic insufficiency that can cause malabsorption is present.

Treatment of chronic pancreatitis

Medical treatment for chronic pancreatitis involves pain control, pancreatic enzyme supplementation, and 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 damage to the pancreas by reducing its stimulation.

  • First, it is recommended that all people with chronic pancreatitis stop consuming alcohol and tobacco in order to slow the progression of the disease.
  • Second, it is also recommended to observe a diet low in fat and divided into several small meals daily. Eating a low-fat diet can help reduce the secretion of pancreatic enzymes and reduce pain. It can also help reduce steatorrhea in the event of malabsorption.
  • Third, in pancreatic insufficiency, taking pancreatic enzymes with meals may help decrease steatorrhea and promote absorption from food. If symptoms persist despite the measures taken, medium chain triglycerides (MCTs) can be used as a source of lipids because their absorption is not dependent 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 people to meet their needs.

References

Article written by:

Marie-Noël Marsan, Nutritionist

 

 

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