Nausea and vomiting
Chronic pancreatitis can trigger nausea, especially after eating fatty foods. Vomiting may happen when the stomach can't empty properly or when pain becomes severe. This can happen due to a pancreatic pseudocyst, gastroparesis, duodenal stricture, medication adverse events, or diabetes.
Diarrhea
It happens when the pancreas doesn't release enough enzymes to break down food, especially fats. When fatty meals are not absorbed, this leads to greasy, loose, or foul-smelling stools. Diarrhea in chronic pancreatitis can also occur from small intestinal bacterial overgrowth.
Fatigue
Chronic pain, nutrients malabsorption, and ongoing inflammation of the pancreas can lead to reduced energy levels and persistent tiredness.
Weight loss
It happens because the body can't properly digest or absorb calories and nutrients. Fear of eating due to pain or nausea may also reduce your appetite and contribute to unintentional weight loss.
Bloating
Bloating is a feeling of fullness or swelling in your belly. In chronic pancreatitis, undigested food can ferment in the gut, causing gas and discomfort. Causes of bloating include gastroparesis, duodenal stricture, small intestinal bacterial overgrowth, and exocrine insufficiency.
Constipation
It means having fewer or harder bowel movements than usual. In chronic pancreatitis, the pain and poor digestion can slow down the bowels, making you feel bloated, have belly pain, or feel like you still need to go even after using the bathroom. In some patients, opioids used for pain can make the bowels move more slowly, causing constipation.
Medication adverse effects
Nonsteroidal Anti-inflammatory Drugs (e.g., ibuprofen, naproxen)
These are used to reduce inflammation and mild pain. They can irritate the stomach lining and increase the chance of developing peptic ulcers or stomach bleeding, especially if taken frequently.
Acetaminophen (Tylenol)
Often used for mild to moderate pain. When taking high doses (over 4 grams per day) can lead to liver damage, especially if you drink alcohol or already have liver issues.
Gabapentin or Pregabalin
These help with pain caused by irritated or sensitive nerves. They may cause drowsiness, dizziness, or feeling off balance. Some people may also gain weight or feel foggy-headed.
Antidepressants (e.g., Duloxetine, Venlafaxine, Amitriptyline, Nortriptyline)
These helps manage pain and mood symptoms like depression or anxiety. They can cause nausea, dry mouth, constipation, drowsiness, weight gain, increased blood pressure, and trouble sleeping in some people.
Antinausea (e.g., Ondansetron, Metoclopramide, Promethazine)
Ondansetron can cause constipation and headache. Metoclopramide may lead to restlessness, drowsiness, and rarely muscle stiffness. Promethazine can cause drowsiness, dry mouth, and dizziness.