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The University of Chicago Medicine pancreatic diseases team is specially trained to collaboratively diagnose and treat pancreatic conditions. Treatment plans for chronic pancreatitis depend on the cause, extent of the disease and the overall health of the patient, meaning your treatment is developed by multiple specialists and designed to fit your needs.
Chronic pancreatitis is a progressive disease characterized by ongoing inflammation of the pancreas. Over time, irreversible damage to pancreatic tissue occurs. Symptoms and complications vary from person to person, but can include abdomen pain, diarrhea, nausea and vomiting.
Several factors help physicians determine the proper diagnosis and treatment, including a detailed review of the patient's medical history. Most treatment plans include therapies to manage pain, as well as the use of medicines and procedures to compensate for poor pancreatic function to ensure proper nutrition. Some patients with chronic pancreatitis develop diabetes, so proper insulin management and diet modifications are important. We offer pancreatitis-specific nutrition consultations to help patients adapt to their lifestyle changes.
Physicians often prescribe narcotics, which may have side effects like constipation and drowsiness. Endoscopic or surgical treatments can also be attempted in certain patients.
Painful chronic pancreatitis or multiple recurrent episodes of pancreatitis that are not controlled with standard medical and surgical treatments may require the removal of the whole pancreas (total pancreatectomy) to relieve severe symptoms
Our pancreatic care team provides long-term outpatient follow-up care to ensure patients are comfortable and that optimal therapy is provided.
The symptoms of chronic pancreatitis include:
While the exact cause of chronic pancreatitis remains somewhat of a mystery, we do know that the risk of developing chronic pancreatitis is increased by a number of factors, including:
Genetic mutations are being recognized more frequently as a cause of chronic pancreatitis. These include hereditary pancreatitis (mutation in the cationic trypsinogen gene, PRSS1); mutations in the gene that causes cystic fibrosis (cystic fibrosis transmembrane conductance regulator gene, CFTR); mutations in the pancreatic secretory trypsin inhibitor gene (SPINK1) and mutations in the chymotrypsinogen gene (CTRC).
A variety of tests are available to assess patients for chronic pancreatitis. These tests include:
Not all tests are performed on every patient.
Each case is different, so treatment is tailored according to symptoms and the cause of the chronic pancreatitis.
Treatments for chronic pancreatitis include the following:
There are a variety of surgical procedures used to treat chronic pancreatitis. At UChicago Medicine, our pancreas care team holds regular meetings where each patient's case is presented and discussed to determine the best approach that will relieve abdominal pain, improve drainage of pancreatic secretions and reduce the chance for future attacks of pancreatitis.
Some patients may benefit from a pancreatic resection (surgical removal of part or all of the pancreas). Others may benefit from a drainage procedure that relieves pressure within the pancreatic ducts. A combined approach that involves both drainage treatments and resection may also be considered. A number of advanced procedures are performed at UChicago Medicine, including:
If resection (removal) of the entire pancreas (total pancreatectomy) is advised, some patients may be eligible for autologous islet cell transplantation, a highly specialized procedure offered in only a few centers worldwide. Islet transplant prevents or reduces the effects of diabetes after pancreas removal. In the past, surgeons were hesitant to remove the pancreas because patients normally developed "brittle diabetes" that was difficult-to-control after surgery. The risk of diabetes posed problems that sometimes outweighed the benefits of pancreas resection. Today, a handful of other U.S. hospitals, including UChicago Medicine, can offer islet transplantation. That allows patients with pancreatitis can undergo pancreas resection to alleviate severe pain without the fear of developing brittle diabetes.
Studies show that patients who have had pancreatic resections at experienced hospitals fare better than people who have the same procedure at smaller hospitals with a lower volume of cases. At UChicago Medicine, our physicians are among the nation’s most experienced pancreatic surgeons, clinical pancreas specialists and islet isolation experts with respect to both the range of alternatives offered and the number of procedures performed.
Total pancreatectomy with islet autotransplantation has emerged as an option for the treatment of debilitating pain in patients with chronic pancreatitis. About 70 percent of patients experience dramatic pain relief after total pancreatectomy with autologous islet cell transplantation.
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