Chronic inflammation of the pancreas is defined as chronic pancreatitis. The disease develops due to alcohol use in 80–85% of cases. However, because of genetic factors, chronic pancreatitis can even be seen as early as 8–10 years of age.
What are the causes of acute pancreatitis?
Autoimmune diseases, in which immune system cells attack the body’s own organs, can also lead to chronic pancreatitis. Despite this, no underlying cause can be identified in about 15% of patients.
What are the causes of acute pancreatitis?
Chronic pancreatitis presents with pain that starts in the middle of the abdomen and radiates to the back. Patients experience a severe pain process that significantly affects their daily lives and that they are often unable to control.
Does chronic pancreatitis turn into pancreatic cancer?
The risk of chronic pancreatitis turning into pancreatic cancer is around 4–5%; however, this risk does not require immediate removal of the pancreas. Therefore, regular follow-up of the patient is essential.
What is the importance of nutrition in acute pancreatitis?
Patients with chronic pancreatitis are often very thin. Because they cannot properly digest what they eat, they frequently experience difficulty gaining weight. For this reason, maintaining a regular and adequate nutrition plan is essential.
How is acute pancreatitis treated?
Since the exact causes are not fully understood, treatment for chronic pancreatitis focuses on relieving symptoms. Chronic pancreatitis attacks may recur several times a year. During these attacks, patients must be treated in a medical facility. With a multidisciplinary approach — involving gastroenterologists, surgeons, and pain specialists — various complications are managed, and the patient’s quality of life is improved.
Because the treatment process can sometimes take up to two weeks, chronic pancreatitis attacks may cause difficulties in both work and social life.
How is the treatment process for chronic pancreatitis planned?
Medical treatment: The treatment of chronic pancreatitis is managed with a multidisciplinary approach and is planned step by step using a “step-up approach”. The first stage consists of medical treatment. Painkillers, medications that regulate blood sugar levels, and pancreatic enzyme supplements to support digestion are given to help the patient.
Endoscopic methods: When the medical approach fails to resolve the problem, endoscopic interventional methods are introduced as the second step.
Chronic pancreatitis can create inflammatory masses in the pancreas. These masses should not be confused with pancreatic cancer. Because they are solid, they may block the pancreas or bile duct and cause complications. In such cases, the pancreatic duct is accessed endoscopically to resolve the obstruction of bile or pancreatic fluid.
Stones may form in the pancreatic duct due to chronic pancreatitis, a condition known as calcification. When these stones block the pancreatic duct, they are removed using a procedure called ERCP (Endoscopic Retrograde Cholangiopancreatography). During this procedure, the pancreatic duct is accessed endoscopically, the stones are cleared, and a stent is placed to allow pancreatic fluid to drain properly.
Surgical methods: If medical methods and endoscopic interventions do not provide results, surgery is recommended. This surgery requires a completely different approach from pancreatic cancer surgery. In chronic pancreatitis operations, organ-preserving surgical techniques are used.
What are the new developments in the treatment of chronic pancreatitis?
Studies show that performing surgery right after the second stage (endoscopy) increases the chance of patients avoiding long-term complications, especially chronic pain. If surgery is not performed within two years when endoscopy fails to give the desired result, the patient’s pain becomes chronic. Because pain is the main problem in chronic pancreatitis, changes occur in the brain’s pain-perception centers. When immune cells attack, neuropathic pain develops. This nerve-related pain becomes difficult to control with standard pain medications. Therefore, choosing surgical treatment early is important to prevent neuropathic pain from developing. Chronic pancreatitis surgeries must also be planned individually according to the patient.