AKT Answer Relating to Causes of Abdominal Pain in Alcohol Dependence

Abstract

Answer A. Chronic pancreatitis may follow episodes of acute pancreatitis or may occur without an identifiable attack. The most common aetiological agent is alcohol but in some patients no satisfactory explanation is available.

Clinical features include abdominal pain, anorexia and weight loss.

Features of exocrine insufficiency include:

Steatorrhoea

Hypocalcaemia

Fat malabsorption

Protein catabolism (due to deficiency of pancreatic proteases)

Features of endocrine insufficiency include impaired glucose tolerance and diabetes mellitus.

Chronic pancreatitis may burn out after many years as the gland atrophies and malabsorption and diabetes develop. Overall, about 25–30% die within 10 years. Pancreatic cancer develops in approximately 4% of patients with a 20 year history of chronic pancreatitis.