Pancreatitis, chronic - Complications of chronic pancreatitis

Damage to your pancreas due to chronic pancreatitis means that further problems are relatively common.

Diabetes

Around half of people with chronic pancreatitis will develop diabetes, usually many years after receiving their diagnosis (it is not unusual for 20 years to pass before diabetes occurs).

Diabetes develops when your pancreas is no longer able to produce insulin. Insulin is a chemical the body uses to break glucose down into energy. The main symptoms of diabetes are:

• feeling very thirsty
• going to the toilet a lot, particularly at night
• extreme tiredness
• weight loss and muscle wasting (loss of muscle bulk)

If you develop diabetes due to chronic pancreatitis, you will probably need to have regular insulin injections to compensate for the lack of natural insulin in your body.

Psychological effects of chronic pancreatitis

Any chronic health condition, particularly one that causes recurring or constant pain, can have an adverse effect on your emotional and psychological health.

One study, which looked at people living with chronic pancreatitis, found that one in seven people had some sort of psychological or emotional problem, such as stress, anxiety or depression.

Contact your GP if you are experiencing psychological and emotional difficulties. Effective treatments are available that can help to improve the symptoms of stress, anxiety and depression.

Joining a support group for people with chronic pancreatitis, such as the Pancreatitis Supporters' Network, may also help. Talking to other people with the same condition can often help to reduce feelings of isolation and stress.

Pseudocysts

Another common complication of chronic pancreatitis is pseudocysts, sacs of fluid that can develop on the surface of your pancreas. They are thought to affect around one in four people with chronic pancreatitis.

In many cases, pseudocysts do not cause any symptoms and are only detected during a computerised tomography (CT) scan. However, in some people, pseudocysts can cause the following symptoms:

• bloating
• indigestion
• dull abdominal pain

If the pseudocysts are small and not causing any symptoms, there may be no need for treatment because they usually disappear on their own.

Treatment will usually be recommended if you are experiencing symptoms or the pseudocysts are larger than 6cm (2.3 inches) in diameter. Larger pseudocysts are at risk of bursting open, which could cause internal bleeding or trigger an infection.

Pseudocysts can be treated by draining the fluid out of the cyst. This can be done by inserting a needle through your skin and into the cyst. Alternatively, an endoscopy may be used. This is where a thin, flexible tube called an endoscope is passed down your throat and tiny tools are used to drain away the fluid.

Sometimes, pseudocysts are treated by removing part of the pancreas using laparoscopic or 'keyhole' surgery. This is known as a laparoscopic distal pancreatectomy. See guidelines from the National Institute for Health and Care Excellence on laparoscopic distal pancreatectomy.

Pancreatic cancer

Chronic pancreatitis increases your risk of developing pancreatic cancer. However, the increased risk is relatively small. For example, it is estimated that for every 100 people with chronic pancreatitis, only one or two will develop pancreatic cancer.

The most common initial symptoms of pancreatic cancer are much the same as chronic pancreatitis. They include jaundice, abdominal pain and weight loss.