Metabolic Aspects of Chronic Pancreatitis

Abstract

There are various causes of metabolic disorders in chronic pancreatitis (Table 1). In the industrialized countries more than 70% of all cases of chronic pancreatitis are caused by alcohol abuse. Thus, one has to differentiate between metabolic disorders as a consequence of chronic ethanol intoxication of various organs such as liver and metabolic disorders related to chronic pancreatitis itself, such as maldigestion. Chronic pancreatitis per se or via

Table 1 Causes of metabolic disorders in chronic pancreatitis

maldigestion may impair absorption. Malassimilation in this disease may, therefore, have several causes. Furthermore, alcohol abuse is often associated with malnutrition which in addition will be responsible for metabolic disorders. Many people who abuse alcohol are smokers. The fate of patients with chronic pancreatitis, therefore, is often complicated by the consequences of smoking such as pulmonary and right heart insufficiency due to chronic bronchitis. Metabolism may be disturbed due to lung cancer and very often due to general arteriosclerosis. Infectious complications have to be kept in mind which often occur in patients with impaired lung function and immune deficiency due to alcohol abuse. Chronic pancreatitis may lead to insulin deficiency. However, I do not want to discuss the whole array of metabolic disorders seen in diabetes.