Pancreatitis is inflammation of the pancreas. The pancreas is a large gland behind the stomach and close to the duodenum - the first part of the small intestine. The pancreas secretes digestive juices, or enzymes, into the duodenum through a tube called the pancreatic duct. Pancreatic enzymes join with bile - a liquid produced in the liver and stored in the gallbladder - to digest food. The pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormones help the body regulate the glucose it takes from food for energy. Normally, digestive enzymes secreted by the pancreas do not become active until they reach the small intestine. But when the pancreas is inflamed, the enzymes inside it attack and damage the tissues that produce them. Pancreatitis can be acute or chronic. Either form is serious and can lead to complications. In severe cases, bleeding, infection, and permanent tissue damage may occur. Both forms of pancreatitis occur more often in men than women.

Chronic pancreatitis is a long-standing inflammation of the pancreas that does not heal or improve and alters pancreas normal structure and functions. It can present as episodes of acute inflammation in a previously injured pancreas, or as chronic damage with persistent pain or malabsorption.

The condition is most often caused by alcohol abuse over many years. Repeat episodes of acute pancreatitis can lead to chronic pancreatitis. Genetics may be a factor in some cases. Sometimes the cause is not known (idiopathic). Other conditions that have been linked to chronic pancreatitis:

• Autoimmune problems (when the immune system attacks the body)
• Blockage of the pancreatic duct or the common bile duct, the tubes that drain enzymes from the pancreas
• Complications of cystic fibrosis
• High levels of a fat called triglycerides in the blood (hypertriglyceridemia)
• Hyperparathyroidism
• Use of certain medicationss (especially estrogens, corticosteroids, thiazide diuretics, and azathioprine)
• Sphincter of Oddi dysfunction (SOD)

Patients with chronic pancreatitis usually present with persistent abdominal pain or steatorrhea resulting from malabsorption of the fats in food (typically very bad-smelling and equally hard on the patient), as well as severe nausea. Diabetes is a common complication due to the chronic pancreatic damage and may require treatment with insulin. Some patients with chronic pancreatitis look very sick, while others don't appear to be unhealthy at all. Considerable weight loss, due to malabsorption, is evident in a high percentage of patients, and can continue to be a health problem as the condition progresses. The patient may also complain about pain related to their food intake, especially those meals containing a high percentage of fats and protein. Some chronic pancreatitis patients do not experience pain while others suffer from constant, debilitating pain. Weight loss can also be attributed to a reduction in food intake in patients with severe abdominal pain.

Abdominal pain

• Greatest in the upper abdomen
• May last from hours to days
• Eventually may be continuous
• May get worse from eating or drinking
• May get worse from drinking alcohol
• May also be felt in the back

Digestive problems

• Chronic weight loss, even when eating habits and amounts are normal
• Diarrhea, nausea, and vomiting
• Fatty or oily stools
• Pale or clay-colored stools

The symptoms may become more frequent as the condition gets worse. The symptoms may mimic pancreatic cancer. Sitting up and leaning forward may sometimes relieve the abdominal pain of pancreatitis.