Answers
What is chronic pancreatitis?
Short answer
Chronic pancreatitis is long-term damage to the pancreas. It causes repeated or constant upper belly pain, and over time oily stools, weight loss and diabetes. In India it often affects young people without any alcohol use (idiopathic or tropical pancreatitis), with stones in the pancreas. Treatment controls pain, replaces digestive enzymes and manages diabetes.
Causes
- Alcohol and smoking
- Idiopathic or tropical pancreatitis, common in India, often starting in young people and sometimes linked to genes
- Repeated attacks of acute pancreatitis
- Very high blood fats (triglycerides) and some other rare causes
Symptoms
- Upper belly pain spreading to the back, often after meals
- Oily, foul-smelling, floating stools that are hard to flush
- Weight loss despite eating
- Diabetes, which may be the first sign
Tests
A CT scan shows stones and changes in the pancreas. MRCP and EUS show the duct and early changes. A stool elastase test checks whether enough digestive enzymes are being made. Blood sugar is checked regularly.
Treatment
People with long-standing chronic pancreatitis have a higher risk of pancreatic cancer, so new weight loss, jaundice or worsening diabetes should be reported promptly.
- Stop alcohol and smoking completely
- Pancreatic enzyme capsules taken with every meal and snack, for oily stools and weight loss
- Pain relief planned with your doctor; avoid self-medicating with strong painkillers
- Endoscopic treatment: stones can be broken by shockwave therapy (ESWL) and cleared, and narrowings stented, by ERCP
- Surgery for some people with pain that does not settle
- Diabetes care, often with insulin, and regular nutrition review
Diet in chronic pancreatitis
Eat more
- Small, frequent meals with protein: dal, curd, paneer, eggs, fish, chicken
- Normal amounts of fat with enzyme capsules, rather than a fat-free diet
- Diabetes-friendly carbohydrates: whole grains and millets, if sugar is high
Cut down
- Alcohol and smoking, completely; both speed up damage and pain
- Large, heavy meals at one time
- Sugary drinks and sweets if you have diabetes
Good to know
- Take enzyme capsules with the first bites of every meal and snack, not after.
- Vitamin D, calcium and bone health are often low; ask your doctor about checking them.
Common questions
Can chronic pancreatitis be cured?
The damage cannot be reversed, but pain, digestion and diabetes can be well controlled, and many people lead a normal working life.
Should I avoid all fat?
No. A very low-fat diet causes weight loss and vitamin deficiency. Eat normal amounts of fat with enzyme capsules.
Does chronic pancreatitis turn into cancer?
The risk is higher than average but still small. Regular follow-up, and early review of new weight loss, jaundice or worsening diabetes, are advised.