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Discussion in 'All Categories' started by Liz - Apr 24th, 2012 8:35 am.
re: pancreatitus by Dr M.K. Gupta - Apr 25th, 2012 12:38 pm
Dr M.K. Gupta
Dr M.K. Gupta
Dear Liz

Chronic pancreatitis typically presents as chronic unrelenting pain with episodic flares. Even though it is sometimes stated that chronic pancreatitis subside with time, the duration of time over which this might occur is extremely variable. Additionally, pancreatic endocrine and exocrine dysfunction may develop as the disease progresses, along with a variety of complications can happen, including pseudocysts, bile duct or duodenal obstruction, pancreatic ascites, splenic vein thrombosis, and pseudoaneurysms.

Thus, natural history of chronic pancreatitis is relatively bleak. Most therapies are targeted at the pancreas by minimizing exocrine pancreatic secretion; unfortunately, this really is relatively ineffective. The goals of treatment include pain management, correction of pancreatic insufficiency, and control over complications. Therapy is similar in patients with acquired and hereditary pancreatitis.

The main characteristic of chronic pancreatitis is abdominal pain. The pain sensation may range from occasional postprandial discomfort to debilitating persistent pain associated with nausea, vomiting, and weight reduction. Pain control can be challenging in some instances. However, when it comes to the right technique to relieve pain, it should be recognized that placebo alone works well in as much as 30 % of patients in many studies.

Treating chronic pancreatitis, principally pain and pancreatic exocrine insufficiency will be treated by medicine. Other complications and their management, the etiology, clinical manifestations, and diagnosis of chronic pancreatitis need thorough evaluation with a physician. We can not prescribe you on internet any definite therapy as treatment varies person to person.

The various treatment modalities for management of chronic pancreatitis are medical measures, therapeutic endoscopy and surgery. Treatment of chronic pancreatitis is directed, when possible, towards the underlying cause, and to relieve pain and malabsorption. Insulin dependent diabetes mellitus may occur and need long-term insulin therapy.

The abdominal pain can be very severe and require high doses of analgesics, sometimes including opiates. Disability and mood troubles are common, although early diagnosis and support can make these complaints manageable. Alcohol cessation and dietary modifications like low-fat diet are essential to handle pain and slow the calcific process. Recent studies have shown smoking can be a high-risk factor.

Replacement pancreatic enzymes in many cases are good at treating the malabsorption and steatorrhea. However, the outcome from 6 randomized trials continues to be inconclusive regarding pain reduction. As the results of trials regarding pain reduction with pancreatic enzyme replacement is inconclusive, some patients will have pain reduction with enzyme replacement and also, since they're relatively safe, giving enzyme replacement to some chronic pancreatitis patient is an acceptable step in strategy to most sufferers. Treatment may be more prone to achieve success in those without involvement of huge ducts and those with idiopathic pancreatitis. Patients with alcoholic pancreatitis may be less likely to reply.

Surgery for Chronic Pancreatitis is commonly split into two areas - resectional and drainage procedures. New and proven transplantation options prevent the patient from becoming diabetic following the surgery of the pancreas from the patient. This is done by transplanting back in the patients own insulin-producing beta cells.

With regards

M.K. Gupta
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