Diabetes mellitus
In chronic pancreatitis, the pancreas becomes damaged over time, affecting its ability to produce insulin, the hormone that controls blood sugar. This can lead to a type of diabetes known as Type 3c diabetes. Unlike type 1 or 2 diabetes, this form is caused by long-term inflammation and scarring of the pancreas. People may not notice symptoms at first, but over time, they can develop high blood sugar, increased thirst, frequent urination, or tiredness. This is why your doctor may screen you for diabetes periodically. Treatment often includes a healthy diet, oral antidiabetics, and insulin.
Diabetes and abdominal pain. Diabetes doesn’t just affect blood sugar; it can also make abdominal pain worse. When blood sugar levels are poorly controlled, it can lead to nerve damage in the digestive system (called diabetic neuropathy). This can cause abdominal pain and discomfort, bloating, or unpredictable bowel movements. Also, high blood sugar levels can slow down digestion and increase the chances of developing gastroparesis, which can worsen pain and bloating.
Exocrine pancreatic insufficiency
Exocrine pancreatic insufficiency (EPI) is a common problem in people with chronic pancreatitis. It happens when the pancreas can no longer make enough digestive enzymes. Without these enzymes, your body can't break down food in the small intestine, especially fats, and can't properly absorb nutrients, even if you're eating well.
EPI usually develops slowly. Symptoms include frequent, greasy or oily stools that are hard to flush, weight loss, bloating, gas, and feeling tired. You may also have vitamin deficiencies, especially vitamins A, D, E, and K, which can manifest as weak bones, poor vision, easy bruising, or increased infections. This is the reason why your doctor may screen your vitamins periodically.
To manage EPI, doctors often prescribe pancreatic enzyme replacement therapy. This can include capsules you may take with meals to help your body digest food better. Eating smaller meals, avoiding alcohol, taking multivitamins, and following a nutrition plan with the help of a dietitian can also help.
With proper treatment, people with EPI can improve their symptoms, gain weight if need, and feel more energetic. Regular follow-up with your doctor is important to optimize your pancreatic enzymes and to monitor vitamin levels.
Osteoporosis
Osteoporosis is a condition where bones become weak and are more likely to break. People with chronic pancreatitis have a higher risk of this, especially if they are low in calcium or vitamin D. Some people also have low levels of weight-bearing activity due to pain or fatigue, which can make bones weaker over time. Osteoporosis doesn't always cause symptoms until a bone breaks, but some may notice back pain or a stooped posture. You may need vitamin D and calcium supplements, and sometimes medication to keep bones strong. Staying active, eating well, and avoiding smoking and alcohol can also help your bones stay healthy. This is the reason why your doctor may do a bone scan periodically to screen for osteoporosis.
Mental health
Living with chronic pancreatitis can be emotionally challenging. The constant pain, dietary changes, and medical treatments can wear you down. Many people feel frustrated, worried, or sad at times. It’s normal to have ups and downs, but when these feelings last, they can affect your overall well-being. Chronic illness doesn’t just affect the body; it affects the mind too. That’s why mental care is just as important as physical care. Talking openly with your doctor, counselor, or support group can help you manage the emotional side of the illness.
Depression
Depression is more common in people with chronic pancreatitis. It's more than just feeling sad, it's a lasting feeling of emptiness, low energy, or not enjoying things you used to. You might have trouble sleeping, eating, or concentrating. Pain and poor digestion can make these feelings worse. Depression can also make it harder to stick to treatments or reach out for support. But it's treatable. Talking therapies, medications, or a mix of both can make a big difference.
Anxiety
Anxiety can show up as constant worry, nervousness, or fear about your health, pain, or the future. For people with chronic pancreatitis, it's common to feel anxious about flare-ups, eating, or how the disease will affect daily life. Anxiety can also cause physical symptoms like a fast heartbeat, stomach discomfort, or sleep problems. It may make you avoid social events or even meals if you fear pain. Like depression, anxiety can be treated with therapy, stress-reducing techniques, or medication. Relaxation exercises, deep breathing, or talking to a therapist can help calm your mind and improve your day-to-day life.
Substance use disorder
Some people with chronic pancreatitis may struggle with alcohol or drug use. Others may become dependent on strong pain medications over time. These situations are very difficult and deserve compassionate, non-judgmental support. If you feel like you're depending on a substance to get through the day, you're not alone and help is available.
Alcohol use disorder
Alcohol is one of the main causes of chronic pancreatitis, but even in those whose condition started for other reasons, continued drinking can worsen symptoms, trigger flares, and speed up damage to the pancreas. Alcohol use disorder means a person has trouble controlling how much or how often they drink, even if it causes harm. For many patients, quitting alcohol completely is one of the most effective steps to reduce pain and avoid hospital visits. It's not easy to stop, especially if alcohol has been used to cope with stress or pain. If you're worried about its use, you need to talk to your doctor and ask for help.
Opioid abuse
Opioids are strong medicines used to treat pain, and many people with chronic pancreatitis are prescribed them when the pain is severe. However, regular use can lead to dependence, where the body needs more of it to feel relief. Some people may begin to rely on opioids to manage not just physical pain, but also stress and emotions. This can lead to opioid use disorder, which may include taking more than prescribed, feeling unable to stop, or needing opioids just to feel "normal".
One long-term effect of opioid use is something called opioid-induced hyperalgesia. This means that instead of helping the pain, the opioids actually make the body more sensitive to it. As a result, people may feel even more pain, especially in the belly.
One of the most worrisome adverse effects of opioids is the risk of overdose, which occurs when breathing slows or stops after taking too much of the drug. Without immediate treatment, this can be fatal. The danger is even greater when opioids are combined with sedatives like benzodiazepines, which can lead to more severe consequences like coma or death. For this reason, follow your doctor's instructions and never mix medications without medical advice.
Drug abuse
The use of recreational drugs like marijuana, cocaine, heroin, or methamphetamines can seriously affect your health. These substances may seem like a temporary escape from pain or stress, but they can damage your organs. Marijuana might reduce pain for some people, but it can also mask symptoms or affect memory and motivation. When drug use becomes a regular habit that affects daily life, it may be a sign of a substance use disorder. If you're using drugs to cope, or if you're worried about their use, please talk to your doctor.
Social isolation
Chronic pancreatitis can make you feel alone. You might stop going out to eat with friends, miss work or school, or feel like others don't understand your pain. Over time, this can lead to social isolation. Feeling cut off from others can worsen mental health and make the illness harder to cope with. Reaching out to loved ones, joining a support group, or talking to others with the same condition can help you feel more connected.
Stigma
Patients with chronic pancreatitis feel judged or misunderstood, especially if their condition is related to alcohol or if they take opioids. Others may feel embarrassed to talk about symptoms like diarrhea or vomiting. This is called stigma—and it can prevent people from getting the care they need.
Some patients report feeling like they are unfairly labeled as alcoholics, even if they have stopped drinking. This can lead to shame, frustration, and a reluctance to talk about their illness or seek help.
Another common stigma involves the use of pain medications. Because chronic pancreatitis often causes severe, long-lasting pain, some patients need opioid treatment. Unfortunately, this can lead to people being seen as "drug-seeking" or treated with suspicion by healthcare providers or even family members.
It's important to know that chronic pancreatitis is a serious medical condition that deserves compassion, respect, and proper treatment. Educating others, advocating for yourself, and seeking support from professionals or patient groups can help reduce stigma. You are not alone, and you deserve to be heard and treated with dignity.