Medications for the Treatment of Chronic Pancreatitis

The pancreas is an organ that’s found behind the stomach. It produces enzymes and hormones that are needed for digestion. The pancreas can become inflamed from illness or injury, which is called pancreatitis. When this inflammation goes on for a long time, it’s called chronic pancreatitis.

This article will discuss some of the available treatment options for chronic pancreatitis, including supplements, pain management medications, endoscopy procedures, and surgery.

Chronic Pancreatitis Medications

Medications may be given to treat chronic pancreatitis. Antioxidants, pancreatic enzymes, and pain medications might be used to help manage symptoms.

Antioxidants and Pancreatic Enzymes

When the pancreas is inflamed, it might not be producing enough of the enzymes that are needed for digestion. This can cause digestive symptoms such as abdominal (stomach) pain, bloating, diarrhea, fatty stools (steatorrhea), intestinal gas, and weight loss.

A combination of pancreatic enzymes and various antioxidants might be the first treatment that’s tried. These medications could help reduce pain for as many as 50% of people who have chronic pancreatitis.

The antioxidants that have been studied in trials for chronic pancreatitis include ascorbic acid, beta-carotene, alpha-tocopherol, selenium, and methionine. These may be given in combination with other medications to control pain.

Pancreatic enzymes are given by prescription. They are used to replace the enzymes that the inflamed pancreas isn’t making or isn’t making in high enough amounts. They are taken at meal time and can help reduce the digestive symptoms that may go along with pancreatitis. 

Pain Medications

Chronic pancreatitis may cause chronic abdominal pain. One type of drug that may be used to relieve the pain is nonsteroidal anti-inflammatory drugs (NSAIDs), which includes Voltaren (diclofenac), Advil or Motrin (ibuprofen), and Aleve (naproxen). These medications may also work to reduce the inflammation in the pancreas.

Another drug that may be prescribed for pain is Lyrica (pregabalin). This drug controls pain by having an effect on the central nervous system. In one study, the combination of antioxidants and Lyrica helped reduce the pain for 50% of people.

Common Side Effects of Chronic Pancreatitis Medications

Lyrica was approved in 2004 and can be prescribed in adults and children over the age of 4. It’s not recommended for use in people who are pregnant or breastfeeding.

Some of the most common side effects are: 

• Blurred vision
• Difficulty with concentration or paying attention
• Dizziness
• Dry mouth
• Edema (swelling)
• Sleepiness or drowsiness
• Weight gain

NSAIDs are available over the counter and as a prescription. The use of NSAIDs long term may come with some risks. "Long-term use" is loosely defined as taking these medications at least three times a week for a period of about three months. The risks with NSAIDs are thought to increase as a person gets older. 

Some of the potential side effects of NSAIDs include: 

• Bleeding in the gastrointestinal (GI) tract
• Increased bruising
• Increased risk of stroke (caused by lack of blood flow to the brain due to blocked or burst arteries), heart attack, and blood clots
• Kidney damage
• Stomach irritation and ulcers (open sores in the stomach)
• Worsening symptoms of asthma (a condition that inflames, swells, and narrows the airways, making breathing difficult)

For the most part, antioxidants are safe to take long term. However, they may have adverse effects if they are taken in amounts that could be toxic. It’s important to follow instructions from a healthcare provider when supplementing with antioxidants in order to avoid any side effects.

Other Treatment Options

Most of the time, chronic pancreatitis is first treated with medications. However, there are endoscopic procedures and surgical techniques that might also be used to treat some people with chronic pancreatitis.

Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic procedure that may be needed in chronic pancreatitis if there is a blockage or if there’s a suspected blockage.

During this procedure, a thin tube is inserted into the mouth and passed down through the esophagus, the stomach, and all the way into the first section of the small intestine.

A catheter is then threaded through the endoscope and into the bile ducts and pancreatic ducts to see if there are any abnormalities. Dye is also sent down through the endoscope, and then X-rays are taken.

Biopsies (small pieces of tissue that are removed and sent to a lab for testing) may also be performed. If there is a blockage in a bile duct or pancreatic duct, it might be possible to remove the blockage or place a stent to treat it.

Surgery is also sometimes used for chronic pancreatitis. Pancreatitis can be associated with stones in the pancreatic bile ducts. These stones can block the pancreatic ducts and prevent the pancreatic juices from traveling through. When that happens, it might be decided to do surgery or an ERCP to take out the stones and improve drainage.

If surgery is determined to be the best option, it can take different forms. It could mean removing part or all of the pancreas. It could also mean removing part or all of some other organs and structures such as bile ducts, gallbladder, stomach, or small intestine.

These operations can be complex and will need to be done by a specialist team. After surgery, the person will need to learn how to live without some or parts of these digestive organs. That could mean taking medications or supplements and going back to a healthcare provider for regular checkups. 

Quitting smoking and avoiding alcohol are other ways to manage chronic pancreatitis and lessen its symptoms.

Is Chronic Pancreatitis Curable?

Unfortunately, there is not a cure for chronic pancreatitis. It’s more accurate to say that this condition is manageable. However, there are good treatment options that can help get the pain and other symptoms of pancreatitis under control.

Summary

Chronic pancreatitis can cause pain and digestive symptoms. Treatments can include nutritional management, supplementing with pancreatic enzymes and antioxidants, pain management, and, in some cases, endoscopy procedures or surgery.

A Word From Verywell

Living with chronic pancreatitis is challenging. It’s important to get the physical aspects of this condition under control. However, coping with pain and the uncertainty of dealing with a chronic condition is also part of living with it.

Talk to your healthcare providers about resources such as support groups with others with the condition, mental health resources, patient advocacy groups, and social workers who can help you navigate this journey.