Treatment of alcoholic pancreatitis.
Chronic pancreatitis is characterized by progressive and irreversible loss of pancreatic exocrine and endocrine function. The majority of cases in the Western world are related to alcohol consumption. Treatment of alcoholic chronic pancreatitis has been difficult, since the mechanisms of disease progression and the causes of pain are poorly understood. The conservative management of chronic pancreatitis focuses on (a) avoidance of precipitating factors such as alcohol and smoking; (b) treatment of pain, and (c) replacement of exocrine and endocrine function. There is a lack of good controlled, randomized treatment trials in alcoholic pancreatitis. However, there is good evidence that lifestyle changes, such as alcohol cessation, hamper progression of the disease. Conservative treatment of pain should be based on a stepwise approach; however, underlying causes such as pseudocysts may require endoscopic or surgical therapy. Treatment of exocrine insufficiency requires pancreatic enzyme supplementation and adjustment to several smaller meals per day, while treatment of endocrine insufficiency requires insulin treatment.
Pfutzer
Roland H
RH
Department of Medicine II (Gastroenterology, Hepatology, Infectious Diseases), University Hospital Mannheim, University of Heidelberg, Mannheim, Germany. roland.pfuetzer@med.ma.uni-heidelberg.de
Schneider
Alexander
A
D000437:Alcoholism / Q000150:complications*; D000700:Analgesics / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004032:Diet; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D010180:Pancreatectomy / Q000379:methods; D010184:Pancreatic Extracts / Q000627:therapeutic use*; D010186:Pancreatic Function Tests; D019512:Pancreatitis, Alcoholic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D050500:Pancreatitis, Chronic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome
D000700:Analgesics; D010184:Pancreatic Extracts