Symptoms of Chronic Pancreatitis | Tropical Pancreatitis | Pancreatic Cancer
Symptoms of Chronic Pancreatitis
- Alcoholic chronic pancreatitis usually presents in 4th or 5th decades of life with a male preponderance.
- Tropical pancreatitis usually affects in younger age group.
Abdominal pain
- It is the main symptom in majority of patients.
- Classical pain is epigastria, persistent, precipitated by heavy meals, with radiation to the back and is relieved by sitting up and leaning forwards.
- Pain may be intermittent and atypical in location.
- Vomiting may occur. In about 20% of cases, the disease is painless.
Diabetes mellitus
- Overt diabetes mellitus occurs in about 1/3rd of patients but over 50% will have glucose intolerance.
- Diabetes is more frequent in tropical pancreatitis.
- Many patients require insulin for diabetes control.
- Incidence of ketoacidosis is less.
Anorexia
- Anorexia and weight loss are common.
- Steatorrhea accounts for weight loss in chronic pancreatitis.
- In tropical pancreatitis, weight loss is not seen due to low fat intake.
- Severe weight loss associated with persistent pain should raise the possibility of super-added pancreatic cancer.
Jaundice
- Obstructive jaundice is more common when complications like pseudo cyst or tumor sets in.
- In alcoholic pancreatitis, pseudo cyst occurs in 20-40% of cases, while in tropical pancreatitis the incidence is only 5-7%.
Physical signs
- There are very few physical signs.
- Epigastric tenderness may be present.
- Jaundice may be present when biliary obstruction sets in.
- Emaciation and signs of nutritional or vitamin deficiency are present in extreme cases.
- A palpable mass indicated pseudo cyst or rarely malignancy.
