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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