What's happening
♂ Men: most often alcohol use disorder
♀ Women: most often biliary disease, which means gallstones
The cardinal symptom is severe pain high in the belly that spreads to the back. Nausea and vomiting come with it, and both are worse after meals, since eating tells the pancreas to send out more enzymes. Chronic pancreatitis wrecks both of its jobs. The exocrine job makes enzymes, so losing it means poor nutrient uptake. The endocrine job makes insulin, so losing it means diabetes.