Chronic pancreatitis is a difficult disease to diagnose and can be easily confused with other conditions. This is a progressive inflammation of the pancreas that triggers permanent structural changes which, in turn, are the cause of the gland malfunction. If you are concerned about suffering from it, it is important to inform your doctor of all symptoms; it is also essential to undergo the appropriate diagnostic tests to reach the correct conclusion or to rule out the possibility of chronic pancreatitis by evaluating other similar diseases.
Steps
Part 1 of 3: Examine the Symptoms
Step 1. Pay attention to unintentional weight loss
One of the typical signs of pancreatitis is weight loss which occurs because the organ is damaged and cannot secrete a sufficient amount of digestive enzymes. All this results in the difficulty of digesting and absorbing food, resulting in malnutrition and weight loss. Here are some criteria for distinguishing weight loss caused by pancreatitis from weight loss triggered by other diseases:
- This symptom is also a characteristic sign of cancer, but in this case the patient complains of other symptoms, such as night sweats, shortness of breath and / or pain in the part of the body affected by the tumor; in the presence of pancreatitis, the person notices weight loss associated with abnormal stools, but rarely reports other complaints.
- Patients who have intestinal disorders, such as inflammatory disease or celiac disease, are often prone to involuntary weight loss. Both of these conditions cause nutrient malabsorption through the gut, preventing the body from maintaining weight. Celiac disease can be identified by measuring antibodies to tissue transglutaminase (tTG-IgA) and a biopsy, if the first test is positive. Chronic inflammatory bowel disease is recognized by blood tests that reveal anemia (reduced red blood cell count), stool analysis for blood traces and colonoscopy (visual inspection of the colon by inserting an endoscope).
- Patients with cystic fibrosis can lose weight unintentionally, because the disease leads to pancreatic problems similar to those of chronic pancreatitis. It can be diagnosed with a sweat test and can ultimately lead to pancreatitis, as the two disorders are interrelated.
Step 2. Check your stool
In the presence of chronic pancreatitis they are usually abnormal; the patient may complain of diarrhea or oily, greasy, light-colored or clay-like excrement. They are also smelly and difficult to flush out. These symptoms can be traced back to digestive problems, as the pancreas releases an insufficient amount of enzymes. The other pathologies that manifest the same symptom are:
- Bowel disorders such as chronic inflammatory diseases, irritable bowel syndrome and so on. They can be diagnosed by analyzing the medical history, the results of blood tests, stools and possibly with a colonoscopy.
- Liver and gallbladder problems can alter the appearance of droppings, but they are detectable through blood tests.
Step 3. Look for pain in the upper abdomen
One of the typical symptoms of chronic pancreatitis is epigastric pain which occurs in the upper part of the belly, but which can radiate to the back, worsens with meals (especially with ingestion of fatty foods) and with drinking (especially alcoholic). Although this severe discomfort is present in the vast majority of patients, there are some people who do not complain of pain, which makes the diagnostic process more complicated. The other pathologies that share this symptom are:
- Liver and / or biliary tract disorders that can be detected by blood tests;
- Muscle or soft tissue trauma;
- Other gastrointestinal diseases that can be ruled out through blood tests, stool tests and even with a colonoscopy.
Step 4. Tell your doctor about all symptoms
Know that if you have all the discomforts typical of chronic pancreatitis (weight loss, fatty and abnormal stools, upper quadrant abdominal pain, and even nausea and / or vomiting), it is likely that you really have this inflammation and not another disease. The reason lies in the fact that although each symptom, taken individually, is relatively non-specific (attributable to various problems), the coexistence of all disorders describes a diagnostic picture of pancreatitis.
- But remember that you need to undergo a series of tests and evaluations to confirm or rule out this chronic inflammation.
- It is not possible to reach a certain diagnosis based on the symptoms alone; however, the complaints are a guide for the doctor and lead him to suspect pancreatitis.
Step 5. Consider your drinking habits
The first risk factor for chronic pancreatitis is alcohol abuse. If you are a heavy drinker (you have been consuming many drinks a day for several years), it is very likely that the symptoms you are experiencing are the manifestation of chronic pancreatitis and not another condition.
Part 2 of 3: Undergo Diagnostic Tests
Step 1. Do a stool test
Given that one of the key signs of this inflammation is the production of abnormal excrements (specifically they are poorly formed, oily, greasy, particularly foul-smelling and light-colored), the examination of the stool is very useful in formulating and confirming the diagnosis. In particular, the levels of fats present are assessed and direct the doctor in the right direction.
Step 2. Go for a blood test
It is used to look for high concentrations of pancreatic enzymes that suggest organ damage. The IgG4 dosage allows us to understand if it is an autoimmune inflammation; however, in general, blood samples are not very useful in identifying chronic pancreatitis.
Step 3. Undergo diagnostic imaging tests
Transabdominal ultrasound allows to visualize the internal organs, including the pancreas; computed tomography or magnetic resonance imaging may prove useful, as may magnetic resonance cholangiopancreatography or endoscopic retrograde cholangio-pancreatography, during which a probe is inserted through the throat to the abdomen to view the pancreas and determine any obstructions and / or signs of pancreatitis.
The doctor decides on a case-by-case basis which specific diagnostic imaging test is most useful and recommends the tests you should undergo
Part 3 of 3: Treating Chronic Pancreatitis
Step 1. Manage the pain
Patients suffering from this condition complain of constant abdominal pain that gets worse with eating, drinking and that is exacerbated by certain foods (such as fats). If you are having a hard time keeping it under control, you need to take pain relievers.
- You can opt for over-the-counter products such as acetaminophen (Tachipirina); adults can take 500 mg every 4-6 hours as needed. Alternatively, you can take ibuprofen (Moment, Brufen), the dosage for adults is 400-600 mg every 4-6 hours as needed.
- If the drugs on sale are not enough, the doctor can prescribe stronger pain relievers, such as narcotics (for example codeine or morphine depending on the level of suffering).
- During pancreatitis-related crises of unbearable pain, some patients need to be temporarily hospitalized to receive painkillers and intravenous fluids until symptoms stabilize. In these cases, people are kept fasted until they feel better, calories are supplied via drip.
Step 2. Modify your diet
If you have been diagnosed with this chronic condition, it is worth consulting a dietician to help you develop a nutrient-rich, low-fat meal plan (pancreatitis causes problems digesting fat). By adhering to a special diet, you allow the body to absorb all the essential substances it needs and at the same time avoid (or minimize) the chances of malnutrition and involuntary weight loss, symptoms that often accompany chronic pancreatitis.
Try to have 5-6 small meals throughout the day, instead of the traditional three larger ones, and try to space them as evenly as possible
Step 3. Take digestive enzyme supplements
Over time, the damage suffered by the pancreas leads to a drastic reduction in the production of these enzymes; as a result, patients suffer from malabsorption and malnutrition, as the body is unable to process and retain the nutrients it needs to function properly and maintain a healthy weight.
- These supplements must be taken before each meal to support digestion every time you sit down to dinner.
- They are also useful for managing pain triggered by the disease.
Step 4. Treat diabetes
The pancreas not only produces and releases digestive enzymes, but also secretes the insulin needed to regulate blood sugar. In the presence of this disease, the damaged organ is unable to guarantee a sufficient quantity of this hormone, leading to diabetes. If you have also been diagnosed with this condition (which often happens in conjunction with the diagnosis of pancreatitis), it is essential to take supplementary doses of insulin to keep the blood sugar level within the norm and avoid potential complications in the long term.
Step 5. Don't drink alcohol
Since the consumption of this substance is one of the major risk factors (and causes) of chronic pancreatitis, you must limit it or, better, eliminate it as soon as you are informed that you suffer from this disease; By also abstaining from smoking, you can manage your symptoms and prevent them from getting worse.
Step 6. Undergo surgery to address an underlying cause
Based on why the disease developed, your doctor may recommend an operation to improve your health condition. Here are some examples:
- Gallstones: if the stones generate an obstruction and are the cause of pancreatitis, they can be removed surgically;
- Blockage of the bile ducts: in this case, the canal is opened or even surgically expanded to eliminate the obstruction and relieve symptoms;
- Presence of fluid or inflammation around or in the pancreas: it is possible to proceed with the removal in the operating room to improve the situation;
- In severe cases, more invasive procedures can be performed, but the risks are very high;
- Surgery is reserved for cases of chronic pancreatitis resistant to conservative medical treatments.
