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Chronic pancreatitis is a long-standing inflammatory disease which leads to scarring of the pancreas and irreversible changes. In the recent years, there has been more research that has found new genes that may be associated with the development of chronic pancreatitis. Congenital abnormalities of the pancreas may become apparent either in childhood or in adulthood.
Other causes of chronic pancreatitis in adults and children include autoimmune pancreatitis and fibrocalcific pancreatitis, also known as tropical pancreatitis, which is more common in India. Symptoms of chronic pancreatitis include abdominal pain, nausea, vomiting, weight loss, diarrhea, and diabetes.
Chronic pancreatitis is diagnosed by a combination of symptoms and imaging tests, including CT or “CAT” scans and MRIs. However, certain features or subtle changes may occur as a result of normal aging rather than chronic pancreatitis.
Another way of to help make the diagnosis of the chronic pancreatitis is to check the pancreatic function. Surgical therapy includes surgically relieving duct obstruction or removing parts of the diseased pancreas.
Andruilli A, Botteri E, Almasio PL, Vantini I, Uomo G, Maisonneuve P, ad hoc Committee of the Italian Association for the Study of the Pancreas. Bertin C, Pelletier AL, Vullierme MP, Bienvenu T, Rebours V, Hentic P, Maire F, Hammel P, Vilgrain V, Ruszneiwski P, Levy P. Hirota M, Shimosegawa T, Masamune A, Kikuta K, Hamada S, Kihara Y, Satoh A, Kimura K, Tsuji I, Kuriyama S, Research Committee of Intractable Pancreatic Diseases. Lowenfels AB, Maisonneuve P, Cavallini G, Ammann RW, Lankisch PG, Andersen JR, Dimagno EP, Andren-Sandberg A, Domellof L. Rebours V, Boutron-Ruault MC, Schnee M, Ferec C, Le Marechal C, Hentic O, Maire F, Hammel P, Ruszneiwski P.
Talamini G, Bassi C, Falconi M, Sartori N, Vaona B, Bovo P, Benini L, Cavallini G, Pederzoli P, Vantini I. Yadav D, Hawes RH, Brand RE, Anderson MA, Money ME, Banks PA, Bishop MD, Baillie J, Sherman S, DiSario J, Burton FR, Gardnr TB, Amann ST, Gelrud A, Lawrence C, Elinoff B, Greer JB, O’Connell M, Barmada MM, Slivka A, Whitcomb DC, North American Pancreatic Study Group. The relationship between race, genetics, and health was somewhat of a blurry one to me before this week. Chronic pancreatitis results in abdominal pain and, in some cases, results in diabetes and fatty stools that are large and bulky. Features of chronic pancreatitis.Chronic pancreatitis is progressive inflammatory process in the pancreas that causes fibrosis (scarring of tissue), calcifications or stones, and dilated pancreatic duct. In addition to alcohol abuse, other causes of acute recurrent pancreatitis include high levels of calcium or triglycerides in the blood, genetic mutations, and congenital abnormalities of the pancreas.
Other causes include genetic mutations, cystic fibrosis, hypercalcemia (or elevated calcium levels in the blood), hypertriglyceridemia (or elevated levels of triglycerides in the blood), autoimmune, or idiopathic, meaning that the cause is still unknown. These abnormalities include annular pancreas, which is an abnormal development of the pancreas during development while in the womb. Causes of Pain in chronic pancreatitis.This figure shows the various factors that may contribute to the pain of chronic pancreatitis. Other causes of abdominal pain that may be confused with chronic pancreatitis.The most common diseases that can cause similar pain as that of chronic pancreatitis includes chronic cholecystitis, biliary strictures, pancreatic cancer, irritable bowel syndrome, peptic ulcer disease, gastric cancer, and constipation, which worsens with certain pain medications. Therefore, a scoring system evaluating a number of abnormalities is more useful for diagnosing chronic pancreatitis in order to separate those with aging pancreas from those with chronic pancreatitis.
Pancreas divisum is not a cause of pancreatitis by itself but acts as a partner of genetic mutations.
High-dose pancreatic enzyme supplementation and fibrosing colonopathy in children with cystic fibrosis. Endoscopic ultrasound guided celiac plexus for managing abdominal pain associated with chronic pancreatitis: a prospective single center experience. Risk of pancreatitis according to alcohol drinking habits: a population-based cohort study.
The different courses of early- and late-onset idiopathic and alcoholic chronic pancreatitis. Cigarette smoking as a risk factor for pancreatic cancer in patients with hereditary pancreatitis.
Impact of etiology on the painful early stage of chronic pancreatitis: a long-term prospective study.
The exacerbation of pancreatic endocrine dysfunction by potent pancreatic exocrine supplements in patients with chronic pancreatitis.
Smoking cessation at clinical onset of chronic pancreatitis and risk of pancreatic calcifications.


Alcohol consumption, cigarette smoking, and the risk of recurrent acute and chronic pancreatitis. CF is a genetic disease characterized by the build-up of mucous throughout the body and its organs.
The CFTR gene codes for a channel protein that transports chloride ions in and out of cells.
This means that both parents have to be carriers of the disease or gene responsible in order to pass it down to their child. As I read the articles and watched the video clips, I realized that race is a social invention, not based on genetic differences. Calcification, which is another sign of chronic inflammation, can develop throughout the pancreas.
Men are up to 1.5 times more likely to have chronic pancreatitis compared to women in the United States (22). Heavy alcohol use, which means 4-5 drinks per day of alcohol over years, increases the risk of developing chronic pancreatitis (8, 21).
Genetic mutations and cystic fibrosis can cause acute recurrent pancreatitis or may cause chronic pancreatitis without prior acute pancreatitis. A gain of function mutation in PRSS1, is associated with premature and continued activation of trypsinogen into trypsin.
A gain of function (which occurs in PRSS1) or a loss of function (which occurs in SPINK1, CTRC, and CFTR) leads to either the premature activation of the enzymes that digest the pancreas (trypsin) or prevents it breakdown (20). Obstruction of the pancreatic duct by strictures or stones may cause increased pressures within the duct.
Another procedure which may help in visualizing the pancreatic duct is an endoscopic retrograde cholangiography, or ERCP. The pancreatic duct is filleted open and a loop of bowel is attached to allow for drainage of the pancreas. Another procedure is known as the pancreaticoduodenostomy or Whipple procedure, which completely removes the head of the pancreas along with a portion of the small bowel (Figure 7b).
This mucous, instead of being slimy, is abnormally thick and sticky, which causes many problems for the individual.
All people, no matter what “race”, are genetically similar, with the exception of different mutations that cause us to be individuals.
These calcifications are like stones that are within the tissue itself, or within the pancreatic duct (Figure 1). Trypsin is flushed into the duodenal to allow for food digestion by bicarbonate rich fluid. A Frey procedure is a combination of the Puestow along with partial removal of the pancreatic head (Figure 7c). Without this water, slimy mucous cannot be properly formed, thereby creating the stickiness. I tried to research why the genes that cause CF are most prevalent in Caucasians, but did not come up with any clear results.
Genetics, though, are based on different base sequences in our DNA that cause different proteins to be made. In 2009, there were 19,724 admissions for chronic pancreatitis in the United States, and associated with annual hospitalization costs of $172 million (16). Alcohol and smoking together increase the risk of chronic pancreatitis as they often coexist.
A loss of function in CFTR prevents adequate formation of bicarbonate fluid, therefore increasing the amount of trypsin around the pancreas. However, there are other possible causes of abdominal pain other than chronic pancreatitis.
This is an endoscopic procedure which uses ultrasound to examine the pancreas at close range.
Another option may be a distal pancreatectomy which will also involve removal of the spleen. This mucous builds up and can block the airways so the person is constantly coughing or wheezing. The passing on of this gene through families is what causes it to be a genetic disease, rather than due to other factors such as social.
I am making the assumption, though, that some sort of genetic mutation in a Caucasian first is what results in more white people having the disease.
Health is based on our genetics rather than our “race.” In one of the videos, a study was talked about where the infant mortality rates of Africans were compared to African Americans and White Americans. An endoscope is a thin, flexible tube that is passed into the mouth and esophagus, down to the stomach and the small bowel.


ERCP may also be used to remove stones in the pancreatic duct and treatment for strictures of the duct. The most common is to measure fecal elastase, an enzyme which is resistant to digestion and normally appears in the stool. Non-narcotic medications are better in the long term as they do not have the complications of narcotic medications. CF can also affect the digestive system by blocking the pancreatic ducts through which digestive enzymes and insulin flow.
Different environmental factors, though, can affect the development of cystic fibrosis (National Library of Medicine). As people mated with others of different “races,” this disease has spread to others (American Lung Association). The results indicated that the African and White American rates were similar, whereas the African American rate was increased.
Continued smoking after the development of chronic pancreatitis speeds up the progression of the disease (19).
This is usually prevented by normal functioning SPINK1, a pancreatic secretory trypsin inhibitor.
The pancreas is right next to the stomach and small intestine so that the examination can be much more accurate.
This can be used to treat pancreatic tumors and chronic pancreatitis that is located only in the head of the pancreas.
This is either done endoscopically (through the stomach) or percutaneously (through the skin). Therefore, it isn’t the genetics or the color of their skin that was responsible, but societal stresses.
However, if there is a loss of function in SPINK1, then trypsin is free to cause inflammation. Both the EUS and ERCP are excellent for diagnosing severe disease; however these tests are invasive procedures and may lead to complications.
This is known as exocrine pancreatic insufficiency and is mainly due to a shortage of pancreatic lipase which is necessary for fat digestion. The risk of EUS alone is the same as a standard upper endoscopy whereas the risk of ERCP has higher risk of post-ERCP pancreatitis. One type of medication that has been shown to have good response in patients with chronic pancreatitis is pregabalin. The islets are removed from the pancreas and given back to the patient by placing them in the liver where they live and function normally. A loss of function of CTRC prevents trypsin breakdown, therefore allowing more trypsin to cause tissue injury. The goal of autoislet transplantation is to prevent the diabetes that would result by removing the entire pancreas. Patients with hereditary chronic pancreatitis will develop exocrine insufficiency at a younger age (18). These are also used in patients with pancreatic exocrine insufficiency but have also been successful in some  without exocrine insufficiency to reduce the pain associated with chronic pancreatitis. Total pancreatectomy removes the entire pancreas, along with a part of the small bowel and spleen. The combination of total pancreatectomy and autoislet transplantation is only performed in specialized centers, and usually for intractable pain. Patients with chronic pancreatitis have a 4% risk of developing pancreatic cancer over 20 years (10).
Pancreatic enzymes help with the digestion of proteins, fat, and carbohydrates, which is otherwise affected in chronic pancreatitis. However the risk of pancreatic cancer is also dependent on the cause of chronic pancreatitis. The inability to digest proteins, fats and carbohydrates leads to what is called maldigestion and weight loss.
For example, smokers with chronic pancreatitis will develop pancreatic cancer earlier than nonsmokers (12, 17).



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