Chronic Pancreatitis

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