Chronic pancreatitis medical therapy

Chronic pancreatitis Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Medical Therapy

The different treatment modalities for management of chronic pancreatitis are medical measures, therapeutic endoscopy and surgery. Treatment is directed, when possible, to the underlying cause, and to relief of the pain and malabsorption. Diabetes may occur and need long term insulin therapy. (Type 1 diabetes)

The abdominal pain can be very severe and require high doses of analgesics. Disability and mood problems are common, although early diagnosis and support can make these problems manageable.

Pancreatic Enzyme Supplementation

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.

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.

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