Question

Which of the following is the most common cause of chronic pancreatitis?

Autoimmune disease

Hereditary disease

Alcohol abuse

Gallstones

Answer 1

Pancreas is located in the upper left quadrant of abdomen behind stomach.The pancreas has two main functions .They are an exocrine function that helps in digestion and an endocrine function that regulates blood sugar.Inflammation of pancreas is called pancreatitis. Pancreatitis which cannot be corrected for long time may lead to chronic pancreatitis.

Causes of chronic pancreatitis may be due to

• Alcohol overuse
• Gall stones
• Autoimmune diseases
• High triglycerides
• Hereditary disorders of pancreas
• Medications
• Cystic fibrosis
• Idiopathic

a. Auto immune disease: Autoimmune disease occurs when body's immune system affect the healthy cells of the body. Autoimmune pancreatitis often occur by other autoimmune diseases such as primary sclerosing cholangitis (PSC), primary biliary cirrhosis, retroperitoneal fibrosis, rheumatoid arthritis, sarcoidosis, and Sjögren's syndrome or idiopathically. About 5-6 % of patients having autoimmune disease are affected by chronic pancreatitis.

b.Hereditary disease: A disease  passed down from parent to child through a defective gene is called hereditary disease like cystic fibrosis . Unidentified chronic pancreatitis may be due to atypical mutations of cystic fibrosis genes passed from families.This occurs in few cases of chronic pancreatitis.

c. Alcohol abuse: Overuse of alcohol leads to acute pancreatitis. When repeated inflammation of pancreas may lead to scar formation and destruction of cells and tissues of pancreas which cannot be regained and are permanent. Alcohol abuse is the main cause of chronic pancreatitis occuring in about 50% of pancreatitis patients.Around seven out of 10 cases of chronic pancreatitis are due to long-term heavy drinking .( Answer)

d.Gallstones: Gallstones, produced in the gallbladder because of more triglycerides in body has ability to block the bile duct and hindering the pancreatic enzymes from traveling to the small intestine and forcing them back into the pancreas. The backflowed enzymes start to cause irritation to the cells of the pancreas, causing the inflammation associated with pancreatitis. But the gall stones cause acute pancreatitis and the relation between gall stones and chronic pancreatitis is still under research.