Chronic pancreatitis is a chronic inflammation of the pancreas. It is not particularly frequent in our country, while it is common in central and northern Europe with alcohol abuse as its main cause. Thanks to the contribution of Professor Alessandro Zerbi, Head of Pancreatic Surgery in Humanitas, we discover the symptoms this pathology manifests as well as the therapeutic options.
Chronic pancreatitis traditionally affects young men, although epidemiology has changed somewhat lately and some women are also affected. It is a rather debilitating disease because when it is established it does not regress and either stabilizes or tends to worsen; its long-term presence is a non negligible risk factor for pancreatic cancer “.
What are the symptoms of chronic pancreatitis?
The main symptom is pain in the high quadrants of the abdomen, between the navel and sternum, which typically has a belt range, and often radiates towards the back. Initially it is a post-prandial pain, which therefore begins after eating, but in the most advanced forms the pain tends to free itself from the intake of food and becomes constant to such an extent that it requires the intake of increasingly strong painkillers”.
How to establish the diagnosis?
The diagnosis makes use of instrumental examinations that highlight the pancreas: the ultrasound analysis can be the first level of examination, and then the CT scan, followed by magnetic resonance and ecoendoscopy “.
How do you treat chronic pancreatitis?
The first step in the treatment of this disease is to try to change one’s lifestyle: it is therefore recommended to reduce alcohol intake as well as smoking, which is often a second cause. It is also necessary to pay more attention to the dietary intake, because these patients are often undernourished, and improve diet through the intake of pancreatic enzyme supplements. Moreover, it is important to pay attention to the absorption of food because those who suffer from chronic pancreatitis produce less pancreatic juices and enzymes and therefore absorb less.
The therapy tries to be as conservative as possible, in the first instance it is behavioral therapy, endoscopic therapy (because it is possible to insert stents inside the pancreas to facilitate the outflow of pancreatic juice), and in the most advanced forms, in which despite these controls the symptoms become increasingly uncomfortable, the pancreas enlarges and compresses the surrounding organs causing difficulties in feeding along with the appearance of jaundice, it is sometimes necessary to resort to surgery, even with partial removal of the pancreas if necessary “, concludes Professor Zerbi.