The pancreas is a gland that releases enzymes, hormones and other secretions that aid in the digestion, absorption, and transport of nutrients and other substances. Chronic pancreatitis (CP) is chronic inflammation of the gland, and can lead to significant pain, nausea, vomiting, malabsorption, malnutrition, pancreatic fibrosis, weight loss, tissue death and type 2 diabetes. In most cases, there is permanent damage to the pancreas. Causes of CP can range from lifestyle choices to congenital abnormalities.
Chronic Alcohol Abuse
Chronic alcohol abuse causes 60 to 70 percent of chronic pancreatitis cases. Chronic exposure to ethanol has a myriad of negative effects on pancreatic cells. Other risk factors, such as inherited enzyme deficiencies, poor diet and smoking, further increase the risk of chronic pancreatitis in long-term alcohol abusers.
Obstructive Chronic Pancreatitis
When the ducts of the pancreas are blocked, enzymes and digestive juices are unable to pass through into the small intestine where they perform their functions of digestion, absorption and nutrient transport. Pancreatic carcinomas, pancreatic tumors, gallstones and kidney stones are common causes of this form of CP.
Enzyme Deficiencies
Certain enzyme deficiencies can cause chronic pancreatitis. The pancreas becomes inflamed in the absence of the enzymes that convert dietary proteins and fats to their respective active form. Over time, fibrosis, or thickening, and necrosis, or death, of the tissue occurs and chronic pancreatitis results. Other congenital conditions such as cystic fibrosis or hyperparathyroidism that also result in enzyme abnormalities can lead to CP.
Pancreatic Fistula
Some patients develop a pancreatic fistula after surgery. A fistula is an abnormal passageway or communication between two organs or vessels that do not usually connect. They are the result of injury, surgery, inflammation or infection. The fistula forms due to leakage of pancreatic juice into the abdomen in conjunction with raw surfaces of the pancreas left behind after surgery. In most cases, the fistula heals itself; however, in some cases it becomes inflamed and results in chronic pancreatitis. On the other hand, chronic pancreatitis is often a cause of a pancreatic fistula.
Tropical Chronic Pancreatitis
Chronic pancratitis is endemic in developing regions such as India, Africa and South America. Dietary toxins and micronutrient deficiencies, as well as possible gene mutations, are believed to be the cause. In these cases, the young tend to be the ones who suffer from CP.
References
- "Nutrition and Diagnosis Related Care"; Sylvia Escott-Stump; 2002
- "Advanced Nutrition and Human Metabolism"; James L Goff and Sareen S Gropper; 2008
- Cleveland Clinic: Chronic Pancreatitis
- "World Journal of Gastroenterology": Pathophysiology of Alcoholic Pancreatitis: An Overview
- USC Dept. of Surgery: Surgery for Acute Pancreatitis
