Chronic pancreatitis medical therapy: Difference between revisions
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=== General recommendations: === | |||
Most of the patients usually improve following the general recommendations with only a few requiring analgesics. | Most of the patients usually improve following the general recommendations with only a few requiring analgesics. | ||
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===== (b) Cessation of alcohol intake: ===== | ===== (b) Cessation of alcohol intake: ===== | ||
====== (c) ====== | ====== (c) Small meals and hydration ====== | ||
===Pancreatic Enzyme Supplementation:=== | ===Pancreatic Enzyme Supplementation:=== | ||
=== Analgesics: === | |||
=== Antioxidants: === | |||
=== Management of complications: === | === Management of complications: === | ||
Revision as of 16:42, 7 November 2017
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Chronic pancreatitis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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American Pancreatic Association Practice Guidelines |
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Chronic pancreatitis medical therapy On the Web |
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American Roentgen Ray Society Images of Chronic pancreatitis medical therapy |
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Risk calculators and risk factors for Chronic pancreatitis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Medical Therapy
The goals of management are:
- Pain control
- Management of pancreatic insufficiency by pancreatic enzyme replacement
- Management of complications[1]
Pain management:
Pain is managed in a stepwise approach of
- General recommendations
- Pancreatic enzyme replacement
- Analgesics
- Other invasive procedures
General recommendations:
Most of the patients usually improve following the general recommendations with only a few requiring analgesics.
(a) Smoking cessation:
(b) Cessation of alcohol intake:
(c) Small meals and hydration
Pancreatic Enzyme Supplementation:
Analgesics:
Antioxidants:
Management of complications:
Replacement pancreatic enzymes are often effective in treating the malabsorption and steatorrhea. However, the outcome from 6 randomized trials has been inconclusive regarding pain reduction.[2]
While the outcome of trials regarding pain reduction with pancreatic enzyme replacement is inconclusive, some patients do have pain reduction with enzyme replacement and since they are relatively safe, giving enzyme replacement to a chronic pancreatitis patient is an acceptable step in treatment for most patients. Treatment may be more likely to be successful in those without involvement of large ducts and those with idiopathic pancreatitis. Patients with alcoholic pancreatitis may be less likely to respond.
References
- ↑ Callery MP, Freedman SD (2008). "A 21-year-old man with chronic pancreatitis". JAMA. 299 (13): 1588–94. doi:10.1001/jama.299.9.jrr80001. PMID 18319401.
- ↑ Warshaw AL, Banks PA, Fernández-Del Castillo C (1998). "AGA technical review: treatment of pain in chronic pancreatitis". Gastroenterology. 115 (3): 765–76. doi:10.1016/S0016-5085(98)70157-X. PMID 9721175.