Acute vs. chronic pancreatitis. Confused about pancreatitis diagnosis?

Last December, my husband was diagnosed with chronic pancreatitis by a family medicine doc. His diagnosis was based on findings from a CT scan.

For a few months prior to the CT scan up till now, he has had the following experience: Every three to four weeks, he has these 2 to 3-day episodes of vomiting up to 10 times a day (sometimes with some blood..sometimes not). he can barely keep liquids down and cannot eat at all during these episodes. He used to have stomach and back pain with these episodes but had no pain during this last “attack” in March.

Now..today I’m very confused because a new family medicine doc has told us that he doesn’t believe my husband has chronic pancreatitis…but acute.

After doing research, I’m confused because when you have as many attacks as my husband has had, wouldn’t that be considered chronic?

Hey..I know this isn’t the best place to get serious medical advice but I thought maybe someone out there had some experience with this condition.

I wasn’t with my husband today at the doc and no..he didn’t ask the doc to expand on the info he was given. My husband has been struggling with depression for years after he was diagnosed with MS and he had to stop running, which was his passion. He handled all of this by drinking alcohol daily, which is most likely why he has pancreatitis. He stopped drinking over a year ago but it wasn’t soon enough to prevent this condition, unfortunately.

He has an appointment with a digestive health doc but it is a 5-week wait to get in…so we are left with info online. Again..just interested in any personal experiences with this disease. Does this sound like chronic or acute? I’m very confused.

thanks for reading.

Answer
Acute pancreatitis is inflammation of the pancreas (and, sometimes, adjacent tissues) caused by the release of activated pancreatic enzymes. The most common triggers are biliary tract disease and chronic heavy alcohol intake. The condition ranges from mild (abdominal pain and vomiting) to severe (pancreatic necrosis and a systemic inflammatory process with shock and multiorgan failure). Diagnosis is based on clinical presentation and serum amylase and lipase levels. Treatment is supportive, with IV fluids, analgesics, and fasting.

Chronic pancreatitis is *persistent inflammation* of the pancreas that results in permanent structural damage with fibrosis and ductal strictures, *followed by a decline in exocrine and endocrine function*. It can occur as the result of chronic alcohol abuse but may be idiopathic.

Initial symptoms are recurrent attacks of pain. Later in the disease, some patients develop malabsorption and glucose intolerance.

Diagnosis is usually made by imaging studies such as ERCP, endoscopic ultrasound, or secretin pancreatic function testing. Treatment is supportive, with dietary modification, analgesics, and enzyme supplements. In some cases, surgical treatment is helpful.

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