Chronic Pancreatitis :: Saint John, NB - Health & Wellness

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Old 09-06-2009
T4 T4 is offline
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Default Topic: Chronic Pancreatitis

Chronic Pancreatitis

Just wondering if anyone else out there suffers from this, and what they do to keep the flare ups at bay. I get upset, because of the constant visits to the ER. I just want to learn how to control it..my own GP...well we won't go there about him. Lets just say that he is FAR from helpful and doesn't listen..you know...only that 1 question per visit rule and no discussions after that.
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Old 09-08-2009
MrsBeasley MrsBeasley is offline
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Default Topic: Chronic Pancreatitis

I haven't had much experience in human medicine or with Chronic Pancreatitis, however I have seen a lot of acute pancreatitis in dogs (usually from eating something extremely fatty like a suet ball, bacon grease etc.). In these cases, hospitalization on IV fluids, fasting (to allow the pancreas to "rest"), IV antibiotics and pain meds. After a few days small amounts of water and food are offered provided the vomiting/diarrhea subside. Once the dog is over the critical period they must remain on a bland low fat diet for lif to help prevent further "falre-ups".

Here's some info that I've found on treating human Chronic Pancreatitis:

PANCREATITIS TREATMENT
— Treatment of chronic pancreatitis can help to relieve pain, improve pancreatic function, and manage complications.

Pain relief — A variety of measures can help relieve the pain of chronic pancreatitis. Simple measures may be sufficient early in the course of the condition, whereas more extensive measures may be needed after several years.

Avoiding alcohol — Avoiding alcohol is the single most important treatment for people with pancreatitis due to alcohol. Alcohol abstinence can improve pain and reduce the risk of acute pancreatitis as well as the risk of dying.
Low fat meals — The pain of chronic pancreatitis may be reduced by eating smaller, low fat meals. Fasting (not eating) for several days may alleviate the pain of chronic pancreatitis, although this is usually done in the hospital so that the person can be given nutrients in intravenous fluids.
Pain medication — Early in the course of chronic pancreatitis, non-prescription pain medications usually control pain. These drugs include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. Doses of these medications are provided in the table (show table 1).
Pancreatic enzyme supplements — Pancreatic enzyme supplements may alleviate pain by decreasing meal-associated stimulation of the pancreas. These enzymes replace the enzymes normally produced by the pancreas, allowing the pancreas to "rest." They are often recommended for people with severe pain. However, these enzymes do not relieve pain in all people.
Narcotic pain medications — Narcotic analgesics (eg, oxycodone and fentanyl) are powerful pain-relieving drugs that require a prescription. These drugs are often recommended if pancreatic enzymes do not relieve pain.
The short-term use of narcotic analgesics can break the pain cycle in some people, while some people require long-term treatment with these drugs. Long-term treatment may be delivered with drug patches that deliver a continuous dose of the drug.

However, a major problem with narcotic analgesics is that some people become addicted to them and thus crave them even when they do not have pain. Thus, most clinicians use them sparingly.

Nerve block — During a nerve block, alcohol or steroids are injected directly into the nerves that carry pain messages from the pancreas; this injection blocks the transmission of pain signals. A nerve block is usually reserved for severe pancreatic pain that does not respond to other types of treatment.
Nerve blocks relieve pain in about 50 percent of people who undergo the procedure. Many people require additional treatments two to six months after the first treatment. The procedure also carries risks that should be discussed with a clinician.

Treatments that widen the pancreatic ducts — Pain may be caused by narrowing and persistent contraction of the pancreatic ducts and the sphincter (muscle) that closes the duct shared by the pancreas and gallbladder. One way to treat this is to place a tube into the narrowed area (stenting).
During stenting, a stiff plastic tube (called a stent) is placed inside the pancreatic duct to hold it open. Preliminary studies suggest that stents can relieve pain in people who have narrowing of the pancreatic duct or pancreatic stones lodged in the duct. However, many studies suggest that stenting has risks. Thus, it is probably only useful for a small percentage of people with chronic pancreatitis.

Pancreatic lithotripsy — Pancreatic lithotripsy refers to a procedure in which shock waves are used to break up stones that have become lodged in the pancreatic duct. This helps to improve the flow of digestive juices. The procedure is being used most often in Europe. It is uncommonly used in the United States, where other methods of treatment are preferred.
Surgery — Surgery is usually reserved for people with chronic pancreatitis who have pain that does not respond to other treatments. Three surgical procedures are available; two of these procedures have been used for many years, whereas one procedure (autologous islet transplantation) is considered to be experimental.

The best time to have surgery is debated. Some studies suggest that early surgery slows the progression of chronic pancreatitis, while others suggest that the condition progresses despite early surgery. At this time, doctors usually recommend surgery for people with chronic pancreatitis who have pain that does not respond to other treatments and who have dilated pancreatic ducts.

Decompression of pancreatic ducts — A surgical procedure called pancreaticojejunostomy relieves obstruction and pressure in the pancreatic ducts. It alleviates pain in about 80 percent of people. For unknown reasons, pain returns within one year in some people who undergo this procedure.
Surgical removal of part of the pancreas — Surgical removal of part of the pancreas relieves pain in some people with chronic pancreatitis. This procedure is usually recommended for people whose pancreatitis is confined to specific parts of the pancreas because only limited amounts of the gland can be removed without compromising its function.
Surgical removal of the pancreas and autologous islet cell transplantation — Although treatments can compensate for most functions of the pancreas, it is difficult to compensate for the pancreas' insulin-producing function. A somewhat experimental treatment of pancreatitis entails surgical removal of the entire pancreas followed by transplantation of the insulin-producing structures from the gland (called islets).
Because the islets are obtained from the person's own pancreas, there is no chance of tissue rejection. Preliminary studies suggest that this procedure relieves the pain of chronic pancreatitis and that about 70 percent of people who undergo this transplantation do not require insulin for as long as seven years after the procedure.

Treatment of greasy stools and digestive problems — Several treatments are available for people who do not absorb enough fat and/or have excessive fat in the stools (steatorrhea). Treatment usually relieves the steatorrhea but does not restore fat absorption to normal levels.

Reducing fat intake — Reducing the amount of fat in the diet can reduce the amount of fat in the stools, causing them to be less greasy. Restricting fat intake to 20 grams per day or less may be recommended.
Lipase supplements — Oral supplements that contain the enzyme lipase can reduce fat malabsorption and steatorrhea. These supplements partially replace the lipase normally produced by the pancreas. Three tablets of pancrelipase (Viokase) taken with meals usually alleviates greasy stools.
Medium chain triglycerides (MCTs) — Medium chain triglycerides, a form of dietary fat, are more easily digested and absorbed than the long chain triglycerides found in most foods. MCTs are a good source of calories for people with chronic pancreatitis who have lost weight and who do not respond to dietary changes or pancreatic enzyme supplements.
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