Conservative treatment of chronic pancreatitis

Pain relief and compensatory therapy of exocrine and endocrine pancreatic insufficiency is the aim of conservative treatment of chronic pancreatitis. Pain relief may be achieved by analgetics, dietary restrictions, alcohol abstinence, enzyme substitution, and operative procedures. Decompensated exocrine pancreatic insufficiency, i.e. steatorrhea, is a late complication of chronic pancreatitis. It requires diet, vitamin, and enzyme replacement. Failure of the latter may be due to inactivation of the enzymes by gastric acid. Finally, diabetes mellitus, secondary to chronic pancreatitis, is managed with diet and insulin. Pancreatogenic diabetes responds only for a short period, if at all, to oral antidiabetics.