Chronic Pancreatitis

Continuous, prolonged inflammatory, and fibrosing process of the pancreas
Etiology
- Alcohol, gallstones, tumor, pseudocysts, trauma, systemic disease
- Acute pancreatitis
- Idiopathic
Classifications
- Two major types
  - Chronic obstructive pancreatitis
    - Inflammation of sphincter of Oddi
    - Cancer of ampulla of Vater, duodenum, or pancreas
  - Chronic non-obstructive pancreatitis
    - Inflammation and sclerosis in head of pancreas and around duct
    - Most common cause is alcohol abuse
Clinical Manifestations
- Abdominal pain
  - Located in same areas as in acute pancreatitis
  - Heavy, gnawing feeling; burning and cramp-like
- Malabsorption with weight loss
- Constipation
- Mild jaundice with dark urine
- Steatorrhea
- Diabetes mellitus
Interprofessional Care
- Pancreatic enzyme replacement
- Bile salts
- Insulin or oral hypoglycemic agents
- Acid-neutralizing and acid-inhibiting drugs
- Antidepressants
Nursing Management
- Focus is on chronic care and health promotion
- Patient and family teaching
  - Dietary control
  - Pancreatic enzyme with meals/snack
  - Observe for steatorrhea
  - Monitor glucose levels
  - Antacids after meals and at bedtime
  - No alcohol

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