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Chronic idiopathic pancreatitis is an inflammation of the pancreas for which no cause can be identified. (Many cases of chronic pancreatitis are associated with excessive consumption of alcohol.) Unlike acute pancreatitis, an inflammation that can cause some temporary damage, chronic pancreatitis is an ongoing, long-term inflammation that can cause permanent scarring and thickening of pancreatic ducts and, ultimately, destruction of the organ. It presents most often with abdominal pain occurring either in discrete episodes lasting hours to days or persisting for months or even years at a time. Diarrhea may also occur, especially with greasy stools (steatorrhea). Because the pain is frequently brought on by eating, appetite may decrease with accompanying weight loss. Diabetes may be a late complication as pancreatic function declines.

Chronic pancreatitis is usually diagnosed by an ultrasound exam, a CT scan, or X-rays of the common bile duct and pancreatic ducts. If you have been diagnosed with this disorder, you should be in the care of a physician who specializes in pancreatic problems. To find one visit: www.pancreasfoundation.org

Conventional treatment of chronic pancreatitis focuses on pain relief plus nutritional support. This may include taking pancreatic enzyme supplements to aid digestion. A low-fat diet usually is recommended, and you may find that eating several small meals is preferable to three larger ones. Keeping well hydrated is also important since, with this condition, dehydration can lead to pain. It's a good idea to carry bottled water with you and to drink frequently throughout the day. Once you're thirsty, you may already be dehydrated.

When pain flares up, you may be better off avoiding food or sticking to clear liquids such as broth, apple, cranberry or grape juice, or gelatin. In general, it is a good idea to stick to foods that are low in protein, avoid anything that is highly spiced and to avoid any food that triggers pain.

I would recommend using anti-inflammatory herbs, especially turmeric and ginger based products. Follow dosage recommendations on the labels or inserts. You might also try traditional Chinese medicine. And I would experiment with mind-body techniques such as hypnosis or guided imagery. These methods should help contain the problem.

Andrew Weil, M.D.