What is chronic pancreatitis?
Chronic inflammation of the pancreas is defined as chronic pancreatitis. The disease develops due to alcohol use at a rate of 80-85 percent. However, due to genetic factors, chronic pancreatitis can occur even from the age of 8-10.
What are the causes of chronic pancreatitis?
Autoimmune diseases, in which cells in the immune system attack their own organs, can also lead to chronic pancreatitis. Despite all this, no cause may be found in 15 percent of patients.
What are the symptoms of chronic pancreatitis?
Chronic pancreatitis manifests itself with the complaint of pain that starts in the middle of the abdomen and reaches the waist. Patients experience pain that is severe enough to affect their lives and that they cannot control.
Does chronic pancreatitis turn into pancreatic cancer?
The risk of chronic pancreatitis turning into pancreatic cancer is around 4-5 percent; however, due to this risk, the pancreas does not need to be removed immediately. Therefore, regular follow-up of the patient is important.
What is the importance of nutrition in chronic pancreatitis?
Patients with chronic pancreatitis are often very thin. This is because chronic pancreatitis patients who cannot fully digest what they eat often have problems gaining weight. For this reason, it is necessary to eat regularly.
How is chronic pancreatitis treated?
Since the causes are not fully known, treatments are applied to prevent the complaints of the disease in chronic pancreatitis. Attacks of chronic pancreatitis may recur several times a year. During these attacks, patients need to be treated in healthcare institutions. With a multidisciplinary approach, patients’ quality of life is improved by intervening in various complications together with gastroenterologists, surgeons and pain specialists.
Since the treatment process can sometimes take up to two weeks, chronic pancreatitis attacks can also cause difficulties in work and social life.
How to plan the chronic pancreatitis treatment process?
Medical treatment: Chronic pancreatitis treatment is handled with a multidisciplinary approach and is planned – step by step – with a method defined as “step up approach”. The first stage is medical treatment. The patient is helped by giving painkillers, drugs that regulate blood sugar levels, and pancreatic enzymes that regulate digestion.
Endoscopic methods: In cases where the medical approach cannot solve the problem, endoscopic interventional methods come into play as the second stage.
Chronic pancreatitis creates an inflammatory tumor in the pancreas. These tumors should not be confused with pancreatic cancer. These tumors, which can block the pancreas or bile ducts because they are solid, can also cause problems. In such cases, the bile fluid or pancreatic fluid flow problem is solved by entering the pancreatic duct endoscopically.
Chronic pancreatitis can cause stones called calcifications in the pancreatic duct. When these stones block the pancreatic duct in the same way, the stones are cleaned by entering the pancreatic duct with a procedure called ERCP (Endoscopic Retrograde Cholangiopancreatography), and a stent is inserted to allow the pancreatic fluid to flow.
Surgical methods: If no results are obtained from medical methods and endoscopic interventional methods, surgery is recommended to the patient. This surgery requires a very different treatment than pancreatic cancer treatment. Organ-preserving surgery is performed in chronic pancreatic surgeries.
What are the new developments in the treatment of chronic pancreatitis?
Studies show that performing surgery immediately after the second stage of chronic pancreatitis treatment, that is, endoscopy, increases the chances of patients getting rid of long-term complications, especially pain. In cases where the desired result cannot be obtained despite endoscopic application, if surgery is not performed within two years, the pain problem of the patients becomes chronic. Since pain is the main problem, especially in chronic pancreatitis patients, the pain perception centers in the brain change. Neuropathic pain occurs in these patients when immune cells attack. It is a created pain coming from the nervous system and neuropathic pains are difficult to control with normal pain medications. For this reason, it is important to choose surgical method in the early period to prevent neuropathic pain. Chronic pancreatitis surgeries also need to be planned specifically for the patient.
