Chronic pancreatitis is a condition where the pancreas becomes inflamed and the inflammation lasts for many years. The long-term inflammation causes the pancreas to become scarred and damaged.
The pancreas
The pancreas is a small, tadpole-shaped organ that is located behind the stomach and below the ribcage. The pancreas has two important functions:
- it produces digestive juices that are used by the intestines to help digest food
- it produces powerful ‘messenger chemicals’ called hormones
Insulin, which regulates the levels of sugar (glucose) in the blood is the most important hormone that is produced by the pancreas.
The most common symptom of chronic pancreatitis is repeated episodes of abdominal pain which can often be severe.
As the damage to the pancreas progresses, it begins to lose some of its functions, which can cause other symptoms, such as:
- producing greasy, foul-smelling stools (faeces)
- diarrhoea
See Chronic pancreatitis - symptoms for more information.
Acute pancreatitis is where the pancreas becomes inflamed quickly and the inflammation usually only lasts for a few days. See the Health A-Z topic about Acute pancreatitis for more information.
Causes of chronic pancreatitis
Alcohol
Persistent and long-term alcohol misuse is the most common cause of chronic pancreatitis. It is estimated that around two-thirds of cases of chronic pancreatitis occur in people who have a history of heavy drinking. This is because in certain individuals alcohol has a toxic (poisonous) effect on the tissue of the pancreas.
Autoimmune pancreatitis
Autoimmune pancreatitis is a recently recognised type of chronic pancreatitis. It occurs when the immune system (the body’s natural defence against illness and infection) mistakenly attacks the tissue of the pancreas. It is thought that 1 in 20 cases of chronic pancreatitis are autoimmune pancreatitis.
Chronic idiopathic pancreatitis
No obvious cause can be found in most of the remaining 25% of cases of chronic pancreatitis. This type of pancreatitis is called chronic idiopathic pancreatitis. Therefore, there is a large minority of people who are affected by chronic pancreatitis who do not have a history of alcohol abuse.
Hereditary pancreatitis
There is a very rare form of chronic pancreatitis known as hereditary pancreatitis, which is caused by genetic mutations that a person inherits from their parents.
A genetic mutation is when the instructions found in all living cells become ‘scrambled’ in some way, meaning that one or more of the processes of the body does not work in the way it should.
Hereditary pancreatitis tends to share the same symptoms as other forms of chronic pancreatitis except the symptoms develop much earlier in life, usually during childhood.
See Chronic pancreatitis - causes for more information.
Treating chronic pancreatitis
In most cases of chronic pancreatitis, there is no specific treatment to reduce the inflammation and repair the damage to the pancreas.
Therefore, treatment mainly focuses on pain relief using painkillers and, in the latter stages of the condition, medications that are designed to replicate the functions of the pancreas. Surgery is sometimes needed to treat severe chronic pain that does not respond to painkillers.
In autoimmune pancreatitis, steroid tablets (oral corticosteroids) usually prove effective in reducing the level of inflammation.
See Chronic pancreatitis - treatment for more information.
How common is chronic pancreatitis?
Chronic pancreatitis is an uncommon condition. Each year, in England, it is estimated that only one new case of chronic pancreatitis is diagnosed for every 11,000 people. However, recently, the rates of chronic pancreatitis have increased because of a rise in alcohol consumption.
Who is affected by chronic pancreatitis?
Chronic pancreatitis that is related to alcohol consumption is most common in middle-aged men who are between 45 and 54 years of age.
Chronic idiopathic pancreatitis can affect adults of all ages.
Women are more often affected by chronic idiopathic pancreatitis than men.
Autoimmune pancreatitis usually first develops between 50 and 60 years of age. It occurs in twice as many men as women. The reason for this is unclear.
Complications
Type 1 diabetes is a common complication of chronic pancreatitis and affects about half of people with the condition. Diabetes occurs when the pancreas is damaged and is unable to produce insulin.
People with chronic pancreatitis also have an increased risk of developing pancreatic cancer.
See Chronic pancreatitis - complications for more information.
Outlook
With the exception of autoimmune pancreatitis (which responds well to treatment), the outlook for most cases of chronic pancreatitis is not good.
The pain can be difficult to treat and can affect a person’s quality of life. However, in many cases, after many years the pain improves or sometimes disappears.
People who do not smoke cigarettes and avoid drinking alcohol usually have a much better outlook. They tend to experience less pain and live longer than those who continue to drink and smoke after receiving a diagnosis.
