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What.is end stage chronic pancreatitis?
The end stage is characterized by steatorrhea and insulin-dependent diabetes mellitus. Several characteristic complications of chronic pancreatitis are known such as common bile duct, duodenal, main pancreatic duct and vascular obstruction/stenosis. Chronic pancreatitis represents a risk factor for pancreatic cancer.
Chronic pancreatitis
Chronic pancreatitis is a persistent and chronic inflammation characterized by irreversible morphological changes and leads to impairment of the patient’s ability to digest food and produce pancreatic hormones. Patients with inflammation may experience a reduced quality of life due to pain.
It most often occurs in patients aged 30-40 years, and is more common in men than in women.
Chronic pancreatitis causes and risk factors
are not yet known, several factors have been identified that may cause it, most notably:
- Excessive drinking of alcohol.
- Having autoimmune diseases.
- Obstruction of the pancreatic duct or common bile duct.
- A family history of pancreatitis.
- A genetic mutation that stops the pancreas from working.
symptoms of chronic pancreatitis
Most people with chronic pancreatitis have several common symptoms, including:
- Pain in the upper abdomen. The pain may spread to the back and get worse with eating or drinking.
- Nausea .
- vomiting;
- Weight loss.
- Anorexia.
- yellowing of the skin and eyes;
- diarrhea.
- Greasy or clay-colored stools.
Diagnosis of chronic pancreatitis
Here are the main diagnostic methods:
1. Imaging tests
Multiple imaging tests, such as an abdominal radiography and a CT scan, can show inflammation, calcium deposits in the pancreas, or changes in the pancreatic ducts.
2. Endoscopic imaging of the pancreas and biliary tract
Endoscopic cholangiopancreatography provides the most accurate visualization and has been the standard for diagnosing chronic pancreatitis, combining the use of endoscopy and fluoroscopy to visualize and treat problems of the bile duct and pancreas.
3. Magnetic resonance imaging of the pancreas and bile ducts
The bile duct and pancreatic systems are imaged, and this procedure is relatively safe, reasonably accurate, fast, and very useful in planning surgical or endoscopic intervention.
4. Ultrasound imaging
The most prominent symptoms that this examination may show for chronic pancreatitis are the presence of stones, cysts, and an expansion of the main pancreatic duct.
5. Biopsy
Sometimes the symptoms of chronic pancreatitis can be very similar to pancreatic cancer, so some may need a biopsy where a small sample of pancreatic cells is taken and sent to a laboratory for examination to rule it out.
Chronic pancreatitis treatment
as soon as it’s diagnosed because repeated episodes of inflammation can cause irreversible damage, and pain relief becomes less effective. Here are the main treatments used:
1. Medication treatment
Pain can be relieved through medications, most notably:
- Pain relievers such as acetaminophen, ibuprofen, or both.
- Mild opioid medicines, such as: Codeine, as they are given if the previous medicines did not relieve the pain.
- Strong opioid medicines, such as morphine.
2. Stent installation
If there is narrowing of the pancreatic duct, a plastic tube called a stent is placed in the duct that can be helpful in relieving pain symptoms .
3. Surgery
When medical treatment fails to provide relief for patients with chronic pancreatitis, surgical treatment may be an option, such as:
-
Lateral pancreaticojejunostomy
Lateral temporal pancreatostomy can relieve pain in up to 80% of patients.
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Whipple procedure
Another surgical procedure that can remove inflammation and lumps on the head of the pancreas, however, this procedure removes a lot of important tissue, so modified Whipple procedures are performed to provide more tissue compared to the classic Whipple procedure, and can be successful in relieving pain and returning to daily activity .
Advice for patients with chronic pancreatitis
Here are some important tips:
- Taking nutritional measures to reduce the effects of pancreatitis is important as the pancreas is involved in the digestive process, so it is recommended to eat six small meals instead of three large meals a day, and a low-fat diet is preferred.
- It is recommended to consult a doctor when feeling anxious, irritable and depressed , as constant pain may lead to this
- Chronic pancreatitis patients are advised to stay away from alcohol to prevent complications and other side effects.