Management of chronic pancreatitis

Giger, Urs; Stanga, Zeno; DeLegge, Mark H (2004). Management of chronic pancreatitis. Nutrition in clinical practice, 19(1), pp. 37-49. Thousand Oaks, Calif.: Sage Publications 10.1177/011542650401900137

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Chronic pancreatitis (CP) is an inflammatory disorder that results in permanent impairment of the glandular anatomy of the pancreas with or without functional abnormalities. The pathogenesis of CP is usually unclear, except in the case of alcohol-induced disease. The most common symptoms of CP are abdominal pain, diarrhea, and weight loss often requiring recurring hospitalization. Over time, pancreatic endocrine and exocrine dysfunction may develop as the disease progresses, and a variety of complications can occur. Among the possible complications are nutrient malabsorption and diabetes mellitus. The treatment of CP is difficult and challenging for every physician. Relieving pain is the first step in treating CP. This symptom needs to be controlled, often with narcotics, which can cause dependence. Diarrhea usually indicates the presence of steatorrhea, which is often treated with a high-calorie, high-protein, and low-fat diet to minimize symptoms of the underlying disease and to promote weight retention or gain. Pancreatic replacement therapy is used to combat maldigestion and malabsorption. Patients with diabetes may need insulin therapy for glycemic control. The use of parenteral nutrition for bowel rest is a standard approach in patients with symptomatic CP. The use of jejunal enteral feeding recently has been evaluated for efficacy in CP patients. The role of pancreatic endotherapy in the management of CP is evolving. Several reports have suggested that endoscopic therapy aimed at decompressing the obstructed pancreatic duct can be associated with pain relief in some patients. Surgery should be considered in patients who fail medical therapy.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition
UniBE Contributor:	Stanga, Zeno
Subjects:	600 Technology > 610 Medicine & health
ISSN:	0884-5336
Publisher:	Sage Publications
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 15:24
Last Modified:	02 Mar 2023 23:23
Publisher DOI:	10.1177/011542650401900137
PubMed ID:	16215095
Web of Science ID:	A19667993100005
URI:	https://boris.unibe.ch/id/eprint/37904 (FactScience: 215088)