With­out pan­creas, fat passes all the way through the body

Manteca Bulletin - - Local / State - Keith Roach, M.D.

DEAR DR. ROACH: I am 57 and gen­er­ally in good health. My doc­tor di­ag­nosed me with chronic pan­cre­ati­tis, af­ter I had weight loss with di­ar­rhea, and was found to have fat in my stool. The CT scan showed that I have a 12-mm stone block­ing my pan­cre­atic duct. He said I have chronic pan­cre­ati­tis. My doc­tor says I need surgery to re­move the stone.

Is this a life-or-death surgery? If no one will per­form the surgery, is there an­other way to get rid of the stone? -- C.H.

AN­SWER: Chronic pan­cre­ati­tis is a rel­a­tively com­mon con­di­tion, but some­times can go for a long time with­out be­ing di­ag­nosed. The pres­ence of fat in the stool is a big clue to the di­ag­no­sis: Pa­tients may no­tice that their stools seem oily, and it might take mul­ti­ple flushes of the toi­let to com­pletely re­move it. The di­ar­rhea hap­pens be­cause the pan­cre­atic en­zymes are nec­es­sary for the body to ab­sorb fat: With­out the pan­creas, the fat passes all the way through the body, caus­ing fatty di­ar­rhea, called steat­or­rhea. Many peo­ple have ab­dom­i­nal pain, some­times episodic, but at least 20 per­cent of peo­ple have none.

There are many causes of chronic pan­cre­ati­tis. Chronic al­co­hol abuse is the most com­mon cause that I saw in my train­ing, but ob­struc­tion of the pan­cre­atic duct by stone or tu­mor is an­other. Un­for­tu­nately, re­mov­ing the stone might not stop the pan­cre­ati­tis: In many peo­ple, the changes in the pan­creas from long­stand­ing ob­struc­tion are ir­re­versible.

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