Chronic pancreatitis

Chronic pancreatitis is a disease of the pancreas that is the result of slow but progressive inflammation. In the long run it causes the replacement of pancreatic tissue with fibrous and non-functioning scar tissue.

Causes 
In about 80% of cases, chronic pancreatitis is the result of excessive consumption of alcohol. However sometimes the onset of the disease depends on other factors such as the presence of genetic defects, the predisposition to develop stones, or malformations of the pancreatic duct.

Symptoms
Like many other diseases affecting the liver, chronic pancreatitis is also initially asymptomatic. Over time the following symptoms may occur:

• digestive difficulties: due to a reduced production of digestive juices by the pancreas, food passes through the intestine without being digested or absorbed sufficiently;
• chronic pain in the abdomen;
• diabetes: due to the incorrect functioning of the pancreas there is an increase in blood sugar, or the presence of sugar in the blood. 

Diagnosis
Chronic pancreatitis may be diagnosed following:

• Laboratory tests (blood tests to verify insufficient pancreatic function or stool tests to evaluate reduced digestive function).
• Diagnostic tests (CT and/or Magnetic Resonance Imaging) to highlight any alterations in the pancreas and the relationships of this organ with the surrounding structures.
• Endoscopic examinations to identify alterations of the pancreatic ducts.

Treatment
In the absence of complications, chronic pancreatitis is treated with:

• a controlled diet (primarily abstaining from alcohol);
• administration of painkillers and/or pancreatic enzymes;
• hypoglycaemic therapy.

In the presence of complications such as chronic recurrent pain (even when painkillers are administered), compression of the choledochus by the pancreas, and the appearance of pseudocysts, it is necessary to perform more "invasive" operations of an endoscopic or surgical nature.