Health Information: Alcohol abuse/misuse and pancreatic disease

The pancreas is an important organ in the back of the abdomen. It acts as a source of many digestive enzymes and hormones. The digestive enzymes come via the duct to the intestine and break down the ingested food of all categories (carbohydrates, proteins, fats). Lack of such enzymes leads to various problems related to indigestion!

Some important hormones come from the pancreas. The most important one is insulin, the deficiency of which leads to diabetes. Glucagon, somatostatin, etc, also have important roles that come from the pancreas as well.

Any inflammation of the pancreas is called pancreatitis. In acute pancreatitis, patients present with severe acute abdominal pain. Patients often describe that pain as a “penetrating through to the back”. Besides many causes, alcohol and gallbladder stones are the two most common causes of acute pancreatitis.

Long-standing alcohol abuse or misuse may lead to chronic pancreatitis. Chronic pancreatitis is a progressive disease that eventually damages the pancreas, and the pancreas loses its function. Pain, malnutrition due to malabsorption, chronic diarrhea, and diabetes are the commonest presentations of chronic pancreatitis.

There is an interesting characteristic of the pain in chronic pancreatitis. The pain worsened after eating something. Due to such pain, the patient often refrains from taking meals. Besides malabsorption, skipping meals also contributes to malnutrition.

An example:

In the case of a thin, malnourished individual who abuses alcohol, if recurrent upper abdominal pain worsens after eating, it is likely a case of chronic pancreatitis.