Less frequent causes
These causes of pancreatitis include viral infections or an endoscopic (i.e. internal) examination called ERCP. This is a method of removing gallstones or stretching the papilla vateri (see above).
Pancreatic cancer
A tumour can also compress the outflow paths and thus cause a backlog of secretion.
Pancreatitis as a result
All these triggering factors then activate the following cascade: First, oedema (swelling caused by water retention) develops, which causes cell damage. The resulting release of various enzymes causes pain and pancreatitis. There are many different causes for the development of chronic pancreatitis and it is not always possible to clearly define the reason for such a disease.
In about 70% of cases, chronic inflammation of the pancreas can occur in connection with long-term alcohol abuse. For this mechanism of development it was found that the daily alcohol consumption of the affected patients was on average more than 150 g over a period of 6 to 12 years. It cannot be assumed, however, that long-term alcohol consumption alone is the cause of the development of chronic pancreatitis.
Clinical studies have shown that alcohol is the sole cause in only 10% of known cases. In most patients, other factors contribute to the development of chronic pancreatitis. Furthermore, it can be stated that the consumption of tobacco products is a clear risk factor.
In contrast to alcohol consumption, smoking is considered an independent trigger. A special form of chronic pancreatitis (chronic pancreatitis) is the so-called hereditary autosomal dominant pancreatitis. This hereditary disease occurs particularly frequently in childhood and brings with it an acute inflammation that occurs in phases.
Sooner or later, these acute inflammatory episodes lead to the development of chronic pancreatitis with self-digesting, inflammatory death of the glandular tissue. The cause is considered to be a mutation in a gene which leads to the self-activation (autoactivation) of various digestive enzymes. In about 15% of the known cases of pancreatitis, there is no identifiable cause for the inflammation of the pancreas.
In addition, various drugs appear to be associated with the development of chronic pancreatitis (chronic inflammation of the pancreas). Among these drugs are diuretics, i.e. drugs that increase urine excretion via the kidneys. Beta-blockers, which are used to treat high blood pressure and coronary heart disease, can also promote chronic inflammatory processes within the pancreas.
In addition, the use of ACE inhibitors, cytostatics, some antibiotics and medicines for epilepsy are also considered a risk factor. Patients suffering from so-called hyperparathyroidism with an increased calcium level, a regulatory disorder of the parathyroid gland, are far more likely to develop chronic pancreatitis in the course of their lives than healthy people. The reason for this finding is that the hormones produced in the parathyroid gland are essential for maintaining normal calcium levels. Finally, a number of genetic factors can also have a favourable effect on the development of this disease.
