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Chronic pancreatitis: complications and management.
M V Apte1, G W Keogh, J S Wilson
1Department of Gastroenterology, Prince of Wales Hospital and University of New South Wales, Sydney, Australia.
Journal of Clinical Gastroenterology
|October 6, 1999
Summary
Chronic pancreatitis causes irreversible pancreatic dysfunction, leading to pain, malabsorption, and diabetes. Advances in enzyme replacement therapy and careful diabetes management are crucial for improving patient outcomes.
Area of Science:
- Gastroenterology and Hepatology
- Endocrinology
Background:
- Chronic pancreatitis involves progressive, irreversible loss of pancreatic function, often linked to alcohol abuse.
- Key complications include abdominal pain, malabsorption, and secondary diabetes, posing significant treatment challenges.
Purpose of the Study:
- To review current research and concepts on the major complications of chronic pancreatitis.
- To discuss clinical issues related to other known complications, including pseudocysts, thrombosis, and cancer.
Main Methods:
- Literature review of recent research and prevailing concepts.
- Discussion of current clinical opinion and treatment modalities.
Main Results:
- Pain management remains challenging, with limited evidence for non-analgesic therapies due to lack of controlled trials.
- Novel bacterial lipase offers potential for more effective malabsorption treatment compared to current enzyme preparations.
- Secondary diabetes is difficult to control and requires cautious insulin therapy to avoid hypoglycemia.
Conclusions:
- Effective management of chronic pancreatitis requires addressing pain, malabsorption, and diabetes.
- Advances in enzyme replacement and careful glycemic control are vital.
- Further research with controlled trials is needed to assess treatment efficacy.