Symptoms of chronic pancreatitis

The article is professionally consulted by Specialist Doctor I Dong Xuan Ha - Department of Medical Examination and Internal Medicine - Vinmec Ha Long International General Hospital.

There are many causes of chronic pancreatitis, of which more than 80% of chronic pancreatitis cases are caused by alcohol abuse. Most cases of chronic pancreatitis usually present with epigastric abdominal pain, pain often worse after eating, pain radiating to the back. The pain can be mild, long-lasting, or severe, persistent. Other accompanying symptoms may be nausea, vomiting, weight loss, steatorrhea,...

The pancreas is an organ located behind the peritoneum, behind the stomach and close to the posterior wall of the abdomen. Pancreatitis occurs when digestive enzymes attack the pancreas causing inflammation and swelling in the pancreas.
Chronic pancreatitis is a disease caused by gradual fibrosis of the pancreatic parenchyma, these pancreases will no longer be able to produce digestive enzymes, which leads to an inability to digest and absorb fats. The production of the hormone insulin also decreases. Consequences will be deterioration or loss of pancreatic function.

First of all, it must be mentioned that the cause of chronic pancreatitis is acute pancreatitis that is not completely treated with reasons such as: unfinished treatment, incorrect treatment method, patients self-discontinue taking drugs.... Besides, other causes leading to chronic pancreatitis are:
Alcoholism: This is one of the main causes of pancreatitis, accounting for about 80-90% of cases. Alcohol damages pancreatic cells causing fibrosis leading to chronic pancreatitis; Patients with pancreatic stones: This cause also accounts for about 80-90% of cases leading to chronic pancreatitis; Due to metabolic disorders: Chronic pancreatitis can be caused by metabolic disorders, especially α1 antitrypsin deficiency, causing stagnation, infection, ... leading to self-destruction of the pancreas, so chronic pancreatitis; Malnourished people: The disease is seen in malnourished people, some autoimmune diseases or can be seen in patients with hyperlipidemia (type of blood triglycerides) causing chronic pancreatitis;

Eating too much iron: People who eat too much iron often have a higher risk of chronic pancreatitis; Genetic factors: Pancreatitis is hereditary, usually in childhood but may go undetected for many years. Hereditary pancreatitis often has recurrent episodes. Each episode lasts from 2 days to 2 weeks; Pulmonary cystic fibrosis: The disease can also be caused by cystic fibrosis; increased calcium in the blood (hypercalcemia); Others: 10-20% of cases of pancreatitis remaining due to drug causes, exposure to certain chemicals, injury from car accident or abdominal trauma, genetic diseases, certain surgical procedures, infections, such as measles (uncommon), pancreatic or intestinal malformations. Chronic pancreatitis is a non-infectious disease. This form of pancreatitis is more common in men than women and usually occurs between the ages of 30 and 40. However, in about 40% of cases of chronic pancreatitis, the cause is unknown.

3.1 Abdominal pain Abdominal pain is the most common chronic pancreatitis symptom in most cases of chronic pancreatitis. The patient will have pain in the area above the navel spreading to the right, to the left and through the back. Pain is infrequent, sometimes a few days or sometimes longer, then the symptoms disappear for a long time, sometimes even months. This sign of chronic pancreatitis usually appears after a full meal with a lot of fat, drinking a lot of alcohol. Sometimes illness occurs after hard work or intense emotions.
Symptoms of pain at first are only dull, abdominal tightness, burning in the area above the navel, then cramping pain, the pain gradually increases in intensity and there are many pains in succession. The pain can last for hours. Patients often sit hunched over to relax the abdominal muscles to relieve pain.
3.2 Malnutrition Due to chronic pain and chronic wall, the patient does not dare to eat a lot of food, in addition, due to chronic pancreatitis, the digestive enzymes secreted by the pancreas do not work to absorb nutrients. Nutrition is limited, thus making it easier for the patient to become thin and lose weight, even though the food is still delicious and the diet is still normal. If the insulin-producing cells of the pancreas are also damaged, diabetes develops at this stage.
3.3 Fat breakdown This is one of the signs of chronic pancreatitis. Often stools have fatty mucus such as nasal mucus, pale stool color, unpleasant odor, and liquid that is difficult to excrete. This condition is caused by a lack of pancreatic enzymes.
3.4 Jaundice Jaundice caused by chronic pancreatitis is only mild and lasts a short time. Jaundice may appear several hours after the pain, but there is usually no fever. Jaundice in chronic pancreatitis is different from jaundice in gallstones, in turn having typical symptoms such as pain, fever, and jaundice.
Symptoms of digestive disorders such as nausea, vomiting occur when there is pain, in addition, it is less obvious.
Clinical examination other than pain rarely detects any specific signs.

In case of symptoms of chronic pancreatitis, you should go to reputable medical facilities to be examined and indicated for definitive treatment of the disease, avoiding unwanted complications.
It is necessary to absolutely abstain from alcohol for people with chronic pancreatitis to reduce the risk of recurrent episodes of acute pancreatitis, prevent the pancreas from getting worse, and prevent complications, even death.
Limit to maximum eating animal fat, fat, food should choose easily digestible, daily need to eat more vegetables, eat more fruit and drink enough water needed.
In case if untreated, the disease progresses gradually, complications usually occur in the first 10 years, most commonly symptoms of malabsorption and diabetes.
Vinmec International General Hospital with full modern technology equipment, advanced examination and diagnosis techniques, always updated with the latest advances in medicine, especially high professional level, rich The experience of doctors and nurses will help accurately diagnose pancreatitis, from which Vinmec's doctors will have specific treatment advice for each case to achieve the highest efficiency.
With 14 years of experience in the field of Endoscopy - Gastroenterology, Doctor Dong Xuan Ha proficiently performs diagnostic gastrointestinal endoscopy techniques, emergency interventions and therapeutic interventions. Currently, he is a gastroenterologist at the Department of General Internal Medicine, Vinmec Ha Long International General Hospital.