Pancreatitis is inflammation of the pancreas, the organ that stores and manufactures digestive enzymes and the digestive hormones insulin and glucagon. Pancreatitis can be acute or chronic. Acute pancreatitis typically comes on without warning and clears up with a course of medication. Chronic pancreatitis worsens with time and leads to irreversible damage to the pancreas. Pancreatitis often leads to malabsorption of key nutrients, including vitamin B-12.
The symptoms of acute and chronic pancreatitis are similar, and often the two conditions are confused, according to the National Digestive Diseases Information Clearinghouse. Both states involve extreme pain in the upper abdomen that may radiate into the back; eating tends to exacerbate the pain. Typically in acute cases, a fever develops; both acute and chronic pancreatitis cause nausea and vomiting. Acute pancreatitis can cause heart or kidney failure; if internal bleeding occurs in the pancreas, death may result.
Malabsorption of essential vitamins and nutrients occurs often in chronic pancreatitis cases. Patients with this condition typically lose weight, even when eating habits remain normal, because the pancreas stops producing digestive enzymes and the body simply excretes all or most of its food. According to Dr. Daniel Rigaud of the Danone Institute, 25 to 45 percent of chronic pancreatitis patients lose the ability to absorb fat-soluble vitamins such as vitamin D, as well as vitamin B-12. Dr. Rigaud ascribes B-12 malabsorption to loss of the pancreatic proteolitic enzymes once damage has completely shut the organ down.
Despite the fact that malabsorption of vitamin B-12 occurs regularly in pancreatitis cases, vitamin B-12 deficiency remains rare. According to a February 1991 study conducted by German researchers and published in the journal "Klinische Wochenshrift," of 137 patients with chronic pancreatitis, only seven exhibited a vitamin B-12 deficiency. Several theories exist to explain this phenomenon, though none are definitive. According to researchers from the University of Edinburgh, patients with pancreatitis do not absorb vitamin B-12 in the fasting state but do absorb it when they eat. This research appeared in the August 1972 issue of "The Lancet."
Acute pancreatitis typically clears up after a few days of intravenous feeding and antibiotics. Treatment for chronic pancreatitis may require synthetic pancreatic enzymes and lifestyle changes, particularly abstinence from alcohol; in some cases surgery is necessary. If a vitamin B-12 deficiency occurs in a patient with pancreatitis, the treatment typically involves vitamin B-12 injections until B-12 levels improve.
- National Digestive Diseases Information Clearinghouse; Pancreatitis; July 2008
- Danone Institute; Nutrition and Chronic Pancreatitis; Dr. Daniel Rigaud; May 1999
- "Klinische Wochenshrift"; Vitamin B12 and Folic Acid Deficiency in Chronic Pancreatitis: A Relevant Disorder?; B. Glasbrenner et al.; February 1991
- "The Lancet"; Does Malabsorption of Vitamin B12 Occur in Chronic Pancreatitis?; J.T. Henderson et al.; August 1972