The treatment of chronic pancreatitis

Hung Hsu Hung, Cheng Hsi Su, Shou Dong Lee

Research output: Contribution to journalArticlepeer-review

Abstract

The traditional definition of chronic pancreatitis (CP) has been permanent and irreversible damage to the pancreas. The damages resulted in both structure and functional abnormalities, including chronic inflammation, fibrosis, steatorrhea and diabetes. The treatment of CP is mainly focused on the symptoms. Abdominal pain is the most common clinical problem and decreased the quality of life. The treatments for pain control included analgesics, antioxidants, pancreatic enzyme therapy, octreotide and endoscopic treatment. The general goal of endoscopic therapy is to improve drainage of the pancreatic duct by relieving ductal obstruction. However, endoscopic treatment is limited due to the pancreatic ductal anatomy. In recent years, the combination of endoscopic treatment and extracorporeal shock-wave lithotripsy (ESWL) improved the success rate of pancreatic duct stone removal and pain control. Maldigestion occurred when approximately 10% of the normal pancreatic output of lipase. Pancreatic enzyme therapy is mainly the solution for steatorrhea. The failure of enzyme replacement therapy is multi-factorial, including inadequate dose, noncompliance, inadequate formulation, and associated with other underlying disease. Diabetes mellitus is an independent risk factor of mortality in chronic pancreatitis. The dose of insulin in chronic pancreatitis is usually lower than insulin-resistant type 2 diabetes mellitus, and the risk of treatment-induced hypoglycemia should be carefully monitored. Although multiple treatment modalities are used in the treatment of chronic pancreatitis, the successful management of chronic pancreatitis relied on the good compliance of patient.

Original languageEnglish
Pages (from-to)190-194
Number of pages5
JournalJournal of Internal Medicine of Taiwan
Volume27
Issue number4
DOIs
StatePublished - Aug 2016

Keywords

  • Abdominal pain
  • Chronic pancreatitis
  • Diabetes
  • Endoscopic therapy
  • ESWL
  • Extracorporeal shock-wave lithotripsy
  • Maldigestion

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