21st April 2024

Chronic pancreatitis

This often presents with epigastric pain, steatorrhea, diabetes (as suggested by raised blood glucose and osmotic symptoms), and malnutrition. It is important to remember that serum amylase may be normal in an acute flare of chronic pancreatitis. The most common cause is alcohol (80%). Other causes include Cystic Fibrosis, recurrent gallstone disease, poorly controlled hemochromatosis, hypertriglyceridemia, and hypercalcaemia.

Faecal elastase can be used to assess exocrine function (this will be low if there is exocrine dysfunction), whilst CT can also be used for diagnosis.

Management involves alcohol and smoking cessation, analgesia, enzyme supplementation (Creon), and proton pump inhibitors.