[Click! Health] Acute Pancreatitis? Chronic Pancreatitis? How Are They Different?

[Asia Economy Reporter Kim Young-won] The pancreas is an important organ responsible for endocrine functions, such as secreting hormones like insulin, and exocrine functions, such as secreting enzymes that aid digestion. Surrounding the pancreas are vital organs and blood vessels including the stomach, liver, spleen, celiac artery, superior mesenteric artery, and portal vein, so damage to the pancreas can affect the entire body. Professor Jo In-rae of the Department of Gastroenterology at Seoul National University Hospital explained, "If pancreatitis becomes chronic inflammation, the risk of developing pancreatic cancer can be up to 18 times higher than that of the general population."

Pancreatitis is classified into acute and chronic types. Acute pancreatitis is an acute inflammatory disease caused by early activation of digestive enzymes due to damage to the pancreas's exocrine function. When the activated digestive enzymes attack the pancreas and surrounding tissues, swelling, bleeding, and necrosis occur, which can lead to systemic inflammatory response and multiple organ failure.

Chronic pancreatitis is a disease in which chronic inflammation causes fibrosis, hardening the pancreas like a stone, and impairing both endocrine and exocrine functions. As fibrosis progresses, pancreatic cells are damaged to the extent that they cannot return to their previous state even with treatment.

60% of Pancreatitis Cases Are Caused by 'Alcohol'

The main cause of pancreatitis is 'alcohol.' Alcohol directly damages pancreatic cells and is identified as a major cause of pancreatitis regardless of whether it is acute or chronic. In fact, alcohol accounts for 60% of chronic pancreatitis cases and 30-60% of acute pancreatitis cases.

About 10% of pancreatitis cases, regardless of acute or chronic, are 'idiopathic pancreatitis,' where the cause is unknown. If recurrent acute pancreatitis of unknown cause occurs, tests should be conducted to check for hereditary or autoimmune pancreatitis, congenital pancreatic duct anomalies, or hidden pancreatic cancer.

Another major cause of acute pancreatitis is 'gallstones.' When gallstones lodge in the sphincter of Oddi, the terminal part of the bile-pancreatic duct, they block the outflow of pancreatic juice. The accumulated pancreatic juice then damages pancreatic cells, causing acute pancreatitis.

Pancreatitis Symptom: Abdominal Pain

The representative symptom of acute pancreatitis is severe upper abdominal pain. Since the pancreas is located toward the back, bending the body forward widens the space between the back and abdomen, which relatively relieves the pain. Other symptoms may include fever, chills, nausea, or vomiting due to inflammatory response, and in severe cases, decreased consciousness and respiratory distress may occur.

The main symptom of chronic pancreatitis is also abdominal pain. When the pancreas becomes fibrotic, pressure inside the pancreatic duct increases, and pancreatic juice is poorly secreted, causing pain. The pain often follows a pattern of lasting several days once it occurs. It is rare for the pain to persist for weeks or months. Additionally, when exocrine function is lost by more than 80% due to chronic pancreatitis, nutrient absorption disorders occur, leading to steatorrhea due to difficulty absorbing fats. If endocrine function also declines, fasting blood glucose abnormalities and diabetes develop, which can cause weight loss.

Prevention Is Key Before Pancreatitis Becomes Chronic

Treatment for acute pancreatitis varies depending on the cause. For alcohol-induced acute pancreatitis, abstinence from alcohol is necessary; if caused by gallstones, cholecystectomy is performed; and if blood lipid levels are high, medication to lower them is administered. However, in general, acute pancreatitis can mostly recover with conservative treatment such as adequate fluid supply and fasting to rest the pancreas.

Chronic pancreatitis is treated symptomatically to relieve symptoms. This includes pain control, digestive enzyme supplementation, and treatment of diabetes and related complications. If the pain is too severe to be managed with analgesics, nerve block procedures, endoscopic procedures to relieve pancreatic duct obstruction, or surgical operations may be performed.

Professor Jo said, "If acute pancreatitis recurs repeatedly, fibrosis progresses, leading to chronic pancreatitis where pancreatic function cannot be restored. Therefore, prevention of pancreatitis is most important." He advised, "Among the preventive measures for acute and chronic pancreatitis that can be practiced daily, the most certain are quitting smoking and alcohol consumption, avoiding greasy foods, and eating a balanced diet of vegetables and fruits."

This content was produced with the assistance of AI translation services.