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Chronic pancreatitis (CP) is a long-term condition for most patients and changes continue to occur over many years. People with mild chronic pancreatitis who stop drinking alcohol and stop smoking have a better prognosis in the outcome of their condition. The most severe symptom and the most difficult symptom to treat is pain. Approximately 33% of patients undergo surgery for management of pain or to prevent further impairment of exocrine or endocrine function. There is no uniform consensus regarding the timing of various treatments or the types of surgery. None of the treatments currently available have particularly high rates of long-term-success and there is often a high rate of recurrence of symptoms.

Patients are treated with increasingly invasive options if conservative treatments are not successful. For example endoscopic management is considered if pain is uncontrolled by medications or if there are causes of pain that can be treated, and surgery will be considered if endoscopic procedures do not provide sufficient relief. Pain typically resolves if untreated after approximately 25 years by which time there may be severe injury to pancreatic tissue. The course of treatment for each patient is highly individual and there are no professional guidelines that determine which type of treatment should be considered or the timing for such treatments.

The overall survival of patients with CP is reduced compared to the general population. Most deaths may not be directly related to CP but rather to medical conditions related to the effects of alcohol or smoking, such as lung cancer, cardiovascular disease, or severe infection.

Studies have shown that patients with alcoholic-related pancreatitis have a higher mortality rate and cancer death rate than the general population and also have a poorer prognosis in general than people with other types of chronic pancreatitis.

Other markers of poor prognosis include:

• Heavy alcohol consumption especially after diagnosis
• Continued smoking
• Presence of insulin-dependent diabetes
• Advanced age