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Chronic Pancreatitis

Pancreatitis is inflammation of the pancreas. The pancreas is a long, thin organ in the middle of the abdomen that secretes different hormones that aid in digestion and glucose control. Some patients may have an acute attack of pancreatitis that comes on and goes away without any long-term consequences. Others unfortunately, will go on to develop chronic pancreatitis after multiple bouts of acute pancreatitis. 

Symptoms

Pain in the abdomen and pain that radiates from the abdomen to the back are characteristic of pain associated with the pancreas. The pain may appear as a “boring,” stabbing type pain. There may be nausea and vomiting associated with the pain as well as tenderness when the abdomen is touched. The pain is usually worse with eating. Chronic pancreatitis is associated with all of these as well as unintentional weight loss and oily or smelly stools.     

Causes

The pancreas is responsible for producing some enzymes that aid in digestion.  Normally these enzymes are activated in the intestine; however, sometimes they become activated in the pancreas itself and harm the cells. This results in the pain associated with pancreatitis. Scarring may occur, resulting in chronic pancreatitis and preventing the pancreas from performing its function of aiding in digestion and producing hormones helping with regulation of glucose.

There are multiple causes of pancreatitis. The most common is related to alcoholism. Other causes or contributing factors include gallstones, medications, smoking cigarettes, cystic fibrosis, infections, high triglycerides and injury to the abdomen.     

Treatments

If suffering from acute pancreatitis, you may need to go to the hospital for administration of fluids and monitoring. For treatment of chronic pancreatitis, you may be referred to a pain management specialist.

At the JLR Center for Pain Medicine, you and your physician will design a treatment plan tailored to you. We will perform a thorough history and complete physical exam. Early treatment focuses on confirmation of the diagnosis and the initiation of a treatment plan to help alleviate pain. Confirmation of diagnosis may include radiological imaging and laboratory testing.

Your treatment plan may involve some lifestyle modifications, addition of pain medication to include a combination of NSAIDS (non-steroidal anti-inflammatories), Tylenol, Tramadol, anti-convulsants (nerve-stabilizing medications), anti-depressant medication and possible mild opioid medication, as well as injection therapy. Your doctor may suggest performance of a celiac plexus block to help alleviate some of the abdominal discomfort. In rare cases, depending on the cause of the pancreatitis, surgery might be indicated.