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Chronic pancreatitis (CP) is an inflammatory condition affecting the pancreas and involves progressive, irreversible damage to the pancreatic tissue. Early chronic pancreatitis may begin with recurrent bouts of acute pancreatitis until later development (over several years) of permanent structural and/or functional impairment including:

• Exocrine insufficiency - impairment in digestion because of dysfunction of pancreatic enzymes and
• Endocrine insufficiency - impairment of insulin production resulting in elevated levels of blood sugar.

Additional characteristics of chronic pancreatitis may include:

• Inflammation
• Fibrotic tissue replacing normal tissue
• Destruction of pancreatic tissue (necrosis)
• Infiltration of inflammatory cells especially into the head of the pancreas
• Acinar cell destruction
• Injury or changes to the pancreatic duct, such as dilatation (widening)
• Development of intraductal stones (calcifications)

The primary and most common symptom associated with chronic pancreatitis is severe pain (experienced by at least up to 75% of patients), either episodic or intractable (unceasing), which significantly impacts quality of life. The pain may actually abate as the condition worsens and the pancreas ceases to function.

The primary structural change of the pancreas in chronic pancreatitis consists of the replacement of healthy pancreatic glandular tissue with scar tissue which affects both exocrine and endocrine function. The glandular cells, which produce pancreatic enzymes that are excreted into the digestive tract, are destroyed leading to impairment in digestion (pancreatic insufficiency). As a result, the patient may lose weight. The undigested food containing fat is evacuated through bowel movements. Patients may experience diarrhea. The stool is rich in undigested fat, often bulky, oily, foul smelling, and difficult to be flushed out of the toilet. This condition is referred to as steatorrhea. As chronic pancreatitis progresses, the insulin producing islet cells may also be destroyed causing diabetes mellitus (Type I).

Progressive chronic pancreatitis may also be associated with the development of complications (outlined below), such as progressive fibrosis, and calcification of pancreatic tissue which may entrap nerves and increase pain. CT imaging might show an enlarged and irregular pancreas with dilated ducts and possible presence of pancreatic cysts. There are some patients in whom the pain actually decreases as pancreatic function diminishes.

Chronic pancreatitis is difficult to diagnose in many patients since its early symptoms can be mistaken for many other digestive or gastric conditions. Estimates are that some patients are not diagnosed until up to 5 years after onset of symptoms because pain patterns are so variable. Chronic pancreatitis may be "clinically silent" in some people until approximately 90% of the pancreas has been affected. It affects men four times as often as women.

In 2001, a classification system called TIGAR-O was published in the journal Gastroenterology to organize the various types of chronic pancreatitis by prevalence as well as by etiology and mechanism of injury to pancreatic tissue. TIGAR-O is an abbreviation of the following:

• T - toxic or metabolic etiology such as alcohol consumption and smoking
• I - idiopathic pancreatitis where a cause cannot be identified
• G - genetic etiology, also known as hereditary pancreatitis
• A - autoimmune etiology of pancreatitis
• R - recurrent severe acute pancreatitis