Chronic Pancreatitis: Causes, Symptoms, Treatment, and Cost

long-lasting inflammation of the pancreas, which is a gland located below the stomach and responsible for producing hormones that control blood sugar levels as well as digestive enzymes, is known as Chronic Pancreatitis.

Chronic Pancreatitis may take many different forms, including:

• Alcoholic Chronic Pancreatitis: Long-term alcohol usage is the main cause of this kind of Chronic Pancreatitis.
• Idiopathic Chronic Pancreatitis: This type of Chronic Pancreatitis has no known cause, but it is believed to be related to genetic and environmental factors.
• Hereditary Chronic Pancreatitis: This type of Chronic Pancreatitis is caused by an inherited genetic mutation that affects the function of the pancreas.
• Obstructive Chronic Pancreatitis: This type of Chronic Pancreatitis is caused by blockages in the pancreatic duct, which can be caused by tumors, scar tissue, or other obstructions.
• Autoimmune Chronic Pancreatitis: This is a rare type of Chronic Pancreatitis that occurs when the immune system attacks the pancreas, leading to inflammation and damage.
• Recurrent acute pancreatitis: This is a condition in which a person experiences multiple episodes of acute pancreatitis, which can eventually lead to Chronic Pancreatitis if left untreated.

Several reasons might lead to Chronic Pancreatitis, including:

• Alcohol abuse: The most frequent cause of Chronic Pancreatitis is substantial alcohol usage over an extended period of time.
• Genetics: Chronic Pancreatitis may be brought on by inherited genetic mutations.
• Autoimmune diseases: Autoimmune diseases can cause chronic inflammation of the pancreas.
• Blockage of the pancreatic duct: Chronic inflammation may result from pancreatic duct obstruction.
• Hypercalcemia: High levels of calcium in the blood can cause Chronic Pancreatitis.
• Hyperlipidemia: Chronic Pancreatitis may result from high blood fat concentrations.
• Infection: Infection of the pancreas can cause chronic inflammation.
• Medications: Certain medications can cause Chronic Pancreatitis.
• Idiopathic: In some cases, the cause of Chronic Pancreatitis is unknown.

The symptoms of Chronic Pancreatitis can vary, but they typically include:

• Abdominal pain: This is the most common symptom of Chronic Pancreatitis. The pain may be dull or sharp, and it may come and go or be persistent. It is usually located in the upper abdomen and may radiate to the back.
• Weight loss: Chronic Pancreatitis can cause malabsorption of nutrients, leading to weight loss and malnutrition.
• Nausea and vomiting: These symptoms may occur due to the inflammation and damage to the pancreas.
• Steatorrhea: This is a condition in which the stools are pale, bulky, greasy, and difficult to flush due to the lack of pancreatic enzymes needed for digestion.
• Diabetes: Chronic Pancreatitis can damage the cells that produce insulin, leading to diabetes in some cases.
• Jaundice: This is a yellowing of the skin and whites of the eyes that can occur if the chronic inflammation leads to blockage of the bile ducts.

There are several ways to avoid developing Chronic Pancreatitis:

• Avoid alcohol consumption: Long-term alcohol usage is a common cause of Chronic Pancreatitis. As a result, abstaining from it or reducing your use may help stop the condition.
• Eat a healthy diet: Having a diet heavy in fat and unhealthy foods might make you more likely to have Chronic Pancreatitis. Hence, a diet heavy in fruits, vegetables, and whole grains and low in fat is advised.
• Manage other health conditions: Certain medical issues, such as excessive triglyceride or cholesterol levels, might make you more likely to have Chronic Pancreatitis. Taking care of these issues may aid in illness prevention.
• Quit smoking: Moreover, smoking increases your chance of getting Chronic Pancreatitis. Giving up smoking may aid in illness prevention.
• Consult a doctor if you have symptoms: It's crucial to see a doctor if you develop symptoms like nausea, vomiting, or stomach discomfort. Early diagnosis and treatment can help prevent Chronic Pancreatitis from developing.

The following tests may be used to identify Chronic Pancreatitis:

• Blood tests: The presence of high amounts of pancreatic enzymes like amylase and lipase may be detected by blood testing.
• Imaging tests: It is possible to see the pancreas and look for indications of inflammation, scarring, or structural abnormalities using imaging tests like an ultrasound, CT scan, or MRI.
• Endoscopic ultrasound (EUS): EUS is a specialized imaging test that uses a small ultrasound probe that is passed down the throat to examine the pancreas and surrounding tissues in more detail.
• Pancreatic function tests: These tests may be used to measure the function of the pancreas, including its ability to produce digestive enzymes and bicarbonate.
• Secretin stimulation test: This test involves the injection of a hormone called secretin, which stimulates the pancreas to produce bicarbonate. The level of bicarbonate in the blood is then measured to assess the function of the pancreas.
• ERCP (Endoscopic retrograde cholangiopancreatography): ERCP is a procedure that involves the use of an endoscope to examine the bile duct and pancreatic duct, and can be used to detect obstructions, narrowing, or structural abnormalities that may contribute to Chronic Pancreatitis.

Possible side effects of Chronic Pancreatitis include the following:

• Infection: The chance of getting pancreatic infections, which may have significant consequences, might rise as a result of Chronic Pancreatitis.
• Malnutrition: Chronic Pancreatitis can affect the ability of the pancreas to produce digestive enzymes, leading to malnutrition and weight loss.
• Diabetes: Since the pancreas may not be able to generate enough insulin to control blood sugar levels, Chronic Pancreatitis may also result in the development of diabetes.
• Pancreatic cancer: The chance of getting pancreatic cancer may rise with persistent pancreatic inflammation.
• Pancreatic pseudocysts: Chronic Pancreatitis can cause fluid-filled sacs to form in the pancreas, known as pseudocysts. If they burst or are infected, they may hurt and lead to additional problems.
• Pancreatic insufficiency: Pancreatic insufficiency, in which the pancreas is unable to generate enough digestive enzymes to adequately break down food, may result from Chronic Pancreatitis. This may result in malabsorption, which may cause vitamin deficits and other problems.
• Chronic pain: Chronic Pancreatitis can cause persistent abdominal pain, which can significantly impact the quality of life and may require long-term pain management.

The following are some natural remedies for Chronic Pancreatitis:

• Triphala Churna: It is a mixture of three fruits- Amla, Haritaki, and Bibhitaki. Triphala helps in detoxifying and rejuvenating the pancreas.
• Kutaja bark: Kutaja bark is known to reduce inflammation of the pancreas and also helps in regulating blood sugar levels.
• Guduchi: Guduchi, also called Tinospora cordifolia, aids in boosting the immune system and lowering pancreatic inflammation.
• Licorice: Licorice root helps reduce inflammation and also helps in repairing the damaged pancreatic tissues.
• Turmeric: In addition to acting as a natural disinfectant, turmeric is well recognized for its anti-inflammatory qualities.
• Diet: A low-fat diet is recommended for people with Chronic Pancreatitis. Avoid foods like fried foods, red meat, dairy products, and alcohol.
• Exercise: Regular exercise helps in maintaining a healthy weight and also reduces the risk of complications associated with Chronic Pancreatitis.
• Acupuncture: Acupuncture works to relieve pain and inflammation by stimulating certain body sites.
• Ginger: Ginger may be ingested in the form of tea or added to meals and is well recognized for its anti-inflammatory qualities.
• Massage therapy: Gentle massage therapy can help in reducing pain and inflammation in the pancreas.

The following foods are suggested for people with Chronic Pancreatitis:

• Low-fat foods: Low-fat diets may lessen the pancreas' workload, which is important in Chronic Pancreatitis. Lean meats, fish, and poultry without skin are all low-fat protein sources.
• Fruits and vegetables: Fruits and vegetables are an important part of the diet since they are full of fiber, vitamins, and minerals. Fruits and vegetables without skins or seeds should be canned or cooked.
• Whole grains: Complex carbs, fiber, and other essential elements may all be found in abundance in whole-grain foods like bread, pasta, and cereal.
• Dairy products: Dairy products should be low-fat or fat-free. Cheese, low-fat milk, and yogurt are all healthy choices.
• Lean protein: Eggs, tofu, and lentils are good alternatives for lean protein sources since they are low in fat.
• Healthy fats: Olive oil, avocados, and almonds are examples of healthy fats that may be consumed in moderation.
• Stay hydrated: Drinking plenty of water and fluids can help prevent dehydration, which is a common complication of Chronic Pancreatitis.

These foods should be avoided in Chronic Pancreatitis:

• High-fat foods: Chronic Pancreatitis makes it difficult for the body to digest high-fat foods, which can further aggravate the symptoms of the disease. These foods can increase inflammation and swelling in the pancreas, leading to more pain and discomfort.
• Sugary foods and drinks: Sugary foods and drinks can also worsen the symptoms of Chronic Pancreatitis. They can cause a sudden spike in blood sugar levels, which puts pressure on the pancreas to produce more insulin, leading to more inflammation and pain.
• Processed foods: Since they often include high levels of salt, fat, and sugar, processed meals are challenging for the body to digest. This can lead to digestive problems and worsen the symptoms of Chronic Pancreatitis.
• Alcohol: Alcohol is one of the leading causes of Chronic Pancreatitis, and it should be avoided completely if you have this disease. Alcohol use may exacerbate pancreatic damage, increasing discomfort and inflammation.
• Caffeine: Caffeine can stimulate the digestive system, which can put pressure on the pancreas to produce more enzymes. This can lead to more inflammation and pain in the pancreas, so it is best to limit your intake of caffeine.
• Fried and greasy foods: Fried and greasy foods are difficult to digest and can worsen the symptoms of Chronic Pancreatitis. These may result in pancreatic edema and inflammation, which would make the pain and discomfort worse.
• Spicy foods: Spicy foods can also cause inflammation and swelling in the pancreas, which can worsen the symptoms of Chronic Pancreatitis. It is best to avoid spicy foods or limit your intake if you have this disease.

Chronic Pancreatitis Treatment includes:

• Pancreaticoduodenectomy (Whipple procedure): The head of the pancreas must be removed during this significant procedure. The gallbladder, bile ducts, and duodenum, the first segment of the small intestine, will also be removed by the surgeon. This procedure is often used for advanced cases of Chronic Pancreatitis when other treatments have failed.
• Distal Pancreatectomy: The pancreas' tail and body are removed during this treatment. This surgery may be recommended if Chronic Pancreatitis affects only the lower part of the pancreas.
• Total Pancreatectomy: In this surgery, the entire pancreas is removed. This may be recommended in severe cases of Chronic Pancreatitis that have not responded to other treatments.
• Pancreas transplant: A pancreas transplant may be recommended for people with severe Chronic Pancreatitis who require insulin therapy. In this procedure, a healthy pancreas is transplanted into the patient's body.

If you suspect that you may have Chronic Pancreatitis, it is recommended to consult a gastroenterologist or a pancreatic specialist for diagnosis and treatment. These experts have training in the diagnosis and treatment of digestive system diseases such as Chronic Pancreatitis.

Here are some common medications that may be used to treat chronic pancreatitis:

• Pancreatic enzyme replacement therapy: These medications help replace the digestive enzymes that the pancreas is no longer able to produce in sufficient quantities. Examples include pancrelipase (Creon, Pancreaze) and pancreatin (Zenpep).
• Pain relievers: Chronic pancreatitis can cause severe abdominal pain, and medications such as acetaminophen, ibuprofen, or opioid painkillers may be prescribed to help manage pain.
• Proton pump inhibitors: These medications help reduce the amount of acid produced by the stomach, which can help alleviate pain and reduce inflammation in the pancreas. Examples include omeprazole (Prilosec), lansoprazole (Prevacid), and esomeprazole (Nexium).
• Insulin: Chronic pancreatitis can cause damage to the insulin-producing cells in the pancreas, leading to diabetes. Insulin injections may be needed to regulate blood sugar levels in patients with chronic pancreatitis who develop diabetes.

In mild cases, with proper management and lifestyle changes, symptoms may improve within a few weeks to a few months. However, in severe cases, recovery may take longer and may require hospitalization and specialised treatment.

Depending on the severity of the ailment and the kind of surgery done, the outcomes of surgery for Chronic Pancreatitis may differ. Some surgeries, such as partial or complete pancreatectomy, may provide permanent relief from symptoms but may also lead to the development of other health issues.
Other surgical procedures, such as drainage of pancreatic ducts or removal of obstructions, may offer temporary relief of symptoms but may require repeat surgeries in the future.

Here are some common medications that may be used to treat chronic pancreatitis:

• Pancreatic enzyme replacement therapy: These medications help replace the digestive enzymes that the pancreas is no longer able to produce in sufficient quantities. Examples include pancrelipase (Creon, Pancreaze) and pancreatin (Zenpep).
• Pain relievers: Chronic pancreatitis can cause severe abdominal pain, and medications such as acetaminophen, ibuprofen, or opioid painkillers may be prescribed to help manage pain.
• Proton pump inhibitors: These medications help reduce the amount of acid produced by the stomach, which can help alleviate pain and reduce inflammation in the pancreas. Examples include omeprazole (Prilosec), lansoprazole (Prevacid), and esomeprazole (Nexium).
• Insulin: Chronic pancreatitis can cause damage to the insulin-producing cells in the pancreas, leading to diabetes. Insulin injections may be needed to regulate blood sugar levels in patients with chronic pancreatitis who develop diabetes.

Here are some estimated costs of various treatments for chronic pancreatitis in India:

• Medications: The cost of medications for chronic pancreatitis can range from a few hundred rupees to several thousand rupees per month, depending on the type of medication and the dosage required.
• Endoscopic treatments: Endoscopic procedures such as pancreatic duct stenting or balloon dilatation can cost between ₹50,000 to ₹1,00,000.
• Surgery: In severe cases of chronic pancreatitis, surgical intervention may be necessary. The cost of surgery can vary depending on the type of procedure required, but it can range from ₹2,00,000 to ₹5,00,000 or more.
• Hospitalization: Hospitalization costs for chronic pancreatitis can vary depending on the length of stay, the type of room required, and the hospital or healthcare facility. On average, hospitalization costs for chronic pancreatitis can range from ₹50,000 to ₹1,00,000 per day.

The side effects of Chronic Pancreatitis treatment can include:

• Inflammation and scarring of the pancreas: Chronic Pancreatitis is a condition where the pancreas becomes inflamed and over time, it gets scarred, which causes damage to the organ's tissues. This damages the organ's function and, as a result, it can't produce digestive enzymes or hormones, and you might experience weight loss and abdominal pain.
• Digestive issues: The pancreas is in charge of creating the enzymes that aid in the body's digestion of meals. When the pancreas is damaged, it can no longer produce enough enzymes to break down food, which can lead to digestive issues such as bloating, diarrhea, and greasy stools.
• Diabetes: Moreover, the pancreas produces the hormone insulin, which aids in blood sugar regulation. When the pancreas is damaged from chronic inflammation, it can no longer produce enough insulin, which can result in diabetes.
• Malnutrition: As the pancreas does not produce enough digestive enzymes to break down food, you might not get enough nutrients from the food you eat, which can cause malnutrition.
• Pancreatic cancer: A higher risk of pancreatic cancer has also been associated with persistent pancreatic inflammation.
• Alcohol addiction: Chronic Pancreatitis is often caused by alcohol abuse. This can lead to addiction problems associated with alcohol abuse.
• Mental Health: Chronic conditions can have a negative and lasting impact on mental health which can worsen the quality of life in patients.