Pancreatitis is a painful and frustrating condition. Overwhelmingly, the major cause of pancreatitis is prolonged heavy drinking. Medical literature indicates that this is the case in more than 80% of pancreatitis patients. Lumped into this statistic is "gall stones" ... I am not sure why there is no distinction between prolonged heavy drinking and gall stones. The other causes of pancreatitis include hereditary, injury, infection, or certain medicines. In rare cases, pancreatitis is defined as "idiopathic", meaning there is no known cause. (Since writing this, I have found research papers that define the causes and relative percentages for both Acute and Chronic Pancreatitis.
In my case, I fall in the "rare" category, I was diagnosed with Idiopathic Chronic Pancreatitis. I am not a drinker (have not had a drink in more than 35 years), and there are no known injuries, infections or medicines that could have caused my pancreatitis.
There are two type sof pancreatitis:
- Acute Pancreatitis
This is the more prevalent condition. The main symptom is severe pain that starts just off-center from the top of the rib cage with a lower grade pain radiating to the back. Symptoms can last anywhere from a few hours to many months. In its most severe form, hospitalization is necessary where the patient is taken completely off of foods (liquid and solid). Nutrients are introduced by intravenous means. What I found to be a surprising statistic is that approximately 30% of those hospitalized with acute pancreatitis perish from the episode. Hospitalization is necessary when other organs are also inflammed or infected.
- Chronic Pancreatitis
Acute pancreatitis does not necessarily lead to chronic pancreatitis. Chronic pancreatitis has the same symptoms, although much less likely to require hospitalization or have other organs infected (or inflammed). With chronic pancreatitis, the pancreas is typically 90% + destroyed or non-functional by the time the pancreatitis becomes an issue. The process can take decades with no specific symptoms ... then all at once, the severe pain strikes. In my case, I can trace the symptoms of the pancreatitis problems going back some 20+ years. At any time I consulted with a physician for stomach cramps, bloating, pains radiating from top of the rib cage to my back, fatigue, loss of stamina, etc. I was incorrectly disagnosed. At first, I was diagnosed with Chronic Fatigue Immune Dysfunction Syndrome, then with Narcolepsy, then with Depression. All diagnoses were then rescinded. It was many years later, and after diagnosis of Type 2 Diabetes, that the severe pains started, leading to a total weight loss of 113 lbs. (51 Kg) and a considerable number of other complications.
While both Acute Pancreatitis and Chronic Pancreatitis are related, they are both quite different. Acute Pancreatitis may be one-time or recurring, but the pancreas is not damaged as a result of an inflammation/pain episode. With Chronic Pancreatitis the pancreas is damaged. I am told by several gastroenterologists that Chronic Pancreatitis is typically not diagnosed until the pancreas is 90% destroyed (scaring or calcification). Chronic Pancreatitis is not the result of recurring Acute Pancreatitis.
Both AP and CP have the same major symptoms: severe pain radiating to the back. Both have the same major causes: long term heavy alchol consumption, gall stones, injury to the pancreas, hereditary, and (rarer) no known cause or idiopathic.
Regardless of the type, the overwhelming symptom is severe pain that is slightly off center at the top of the rib cage with pain radiating to the back. There are no known specific treatments for pancreatitis, the best that the medical community can offer is pain management.
After much research on pancreatitis focusing on medical research and university research projects, I have come to the conclusion that the best course of action for myself is to focus on reducing inflammation and reducing the possibility of inflammation. I know it sounds trite, pancreatitis is after all inflammation of the pancreas. However, the medical community focuses on treating symptoms – not necessarily causes. That means that visting your local hospital or doctor for pain flare-ups means that you will be offered pain reducing prescriptions, and not necessarily anything to reduce inflammation. I have been to the hospital Emergency department several times for this severe pain. In both cases, I was given only pain medication (a narcotic and a prescription-strength NSAID).
So, I actively plan my meals around foods that do not cause inflammation: any spicy food is, for the most part, not part of my diet. Acidic foods and liquids are also out. I do take supplements that are primarily to reduce inflammation.
I discuss natural supplements on this site with citations. One of the most useful has been a homeopathic compound called Arnica Montana. One of the pain medicines I have taken in the past is Ibuprofen ... this is a no no. It will reduce the pain short-term, but Ibuprofen will cause further damage to the pancreas. Nevertheless, doctors will also recommend taking ibuprofen short-term. Ibuprofen is fairly quick acting, often reducing or eliminating the pain within 20 minutes. I found, though, that Arnica Montana will start working within 2 minutes and more often completely remove the pain ... I need to point out this is not severe pain. This is the type of pain that is the startup of a major flare-up. So far, in more than one year, I have been able to avoid flare-ups by taking Arnica Montana when I get the startup pains.
The pancreas has two majors functions in the body. It produces insulin and a bile containing digestive enzymes. If the pancreas is inflammed, production of insulin and digestive enzymes is compromised. This can lead to diabetes, and often does, as well as digestion problems. Digestion problems can include flatulence (gas), steatorrhea (oil in stools), constipation or diarrhea, weight gain or weight loss.
Dealing with pancreatitis on an on-going basis is a major challenge. Some of the worst complications include severe diarrhea (actually, violent diarrhea is a better description), steatorrhea (oil in stools), and extreme weight loss.
I have a few tips for dealing with these symptoms (I have had them all). There is nothing that I can do about the weight loss. Foods that can increase your weight are not good for your pancreas and will cause more frequent pain flare-ups and contribute to worsening the symptoms. In the case of flatulence, eat fewer carbs and take Beano. For steatorrhea, take one tablespoon of psyllium in the morning and one tablespoon of psyllium in the evening. Psyllium will also help make you feel fuller – but its main use is to absorb the steatorrhea oil. Steatorrhea oil can be a pale colour all the way to dark red/brown. The oil is the undigested fats from the foods you ate. Unfortunately, steatorrhea also has its own complications, including bathroom "accidents" ... it is almost impossible to hold the oils in until you make it to the toilet, meaning it "leaks" out to your clothing. Steatorrhea oil is impossible to remove from clothing or furniture and difficult to remove from the toilet bowl. When you eat fatty foods, always select the leanest cuts of meat, and avoid foods where you cannot control the amount of fat included – and use psyllium.
Pancreatitis, whether Acute or Chronic, is one of those diseases that has no "visibility", that is someone looking at you would not make a link between your appearance and an illness. There are other illnesses and diseases like this – totally dilibitating, but non-visible. Those suffering from Chronic Immune Disfunction Syndrome, Chron’s Disease, Colitis, etc. all report the same type of issues with friends and family dis-believing them. This is not restricted to friends and family, it also happens with the medical community too. It is disheartening to visit the ER only to over-hear nurses discussing your case suggesting you may be a pill chaser looking for narcotics. The other aspect of the medical community I find difficult to accept is the assumptions made about AP or CP: assuming that it is caused by alcoholism. I have heard horror stories of AP/CP patients waiting in the ER for many many hours with no pain relief offered ... only to get a sense the staff think they brought this on themselves from drinking. Isn’t the pain the same as anyone else?
There is a way of dealing with these situations, that is with education and persistence in explaining the disease itself. Detach yourself from being a sufferer and become an educator. I find myself challenging even my own doctors and nurses when I feel I need to make a point about my own health. I honestly do not care what they think of how I look ... what I want them to understand is my symptoms, my disease, and I will go to great lengths to make my point, without emotion, with statistics, and with passion.
It still hurts though, particularly when family and friends make you feel like a hypochondriac and/or suggest some stretching of the truth ... best of luck with these jerks.