Pancreatitis, Chronic: eMedicine Gastroenterology. The cause of chronic pancreatitis usually is metabolic in nature.
The proposed pathologic mechanisms of chronic pancreatitis are as follows: Intraductal plugging and obstruction - Eg, ethanol (ETOH) abuse, stones, tumorsDirect toxins and toxic metabolites - These act on the pancreatic acinar cell to stimulate the release of cytokines, which stimulate the stellate cell to produce collagen and to establish fibrosis; cytokines also act to stimulate inflammation by neutrophils, macrophages, and lymphocytes (eg, ETOH, tropical sprue) Oxidative stress - Eg, idiopathic pancreatitisNecrosis-fibrosis - Recurrent acute pancreatitis that heals with fibrosisIschemia - From obstruction and fibrosis; important in exacerbating or perpetuating disease rather than in initiating diseaseAutoimmune disorders - Chronic pancreatitis has been found in association with other autoimmune diseases, such as Sjögren syndrome, primary biliary cirrhosis, and renal tubular acidosis.
COPD. Psychiatric Medications.