Chronic pancreatitis.
OBJECTIVE
We review important new clinical observations in chronic pancreatitis made in the last year.


RESULTS
Cholecystokinin-stimulated endoscopic pancreatic function testing has low specificity for diagnosis of early chronic pancreatitis, likely because of correctable technical limitations or failure to exclude confounding diseases. Fecal elastase 1 is a poor test for diagnosing pancreatic malabsorption. A 2-week trial of corticosteroids may differentiate autoimmune pancreatitis (AIP) from pancreatic cancer in select patients. A genetic screen may help to predict relapse of AIP. Repeated, 6-month visits to counsel against alcohol use may reduce recurrent attacks of alcoholic pancreatitis. A five-component antioxidant cocktail may reduce the frequency of pain in chronic pancreatitis by 1.5 days per month.


CONCLUSIONS
Researchers this last year have further characterized clinical aspects of chronic pancreatitis that may lead to improved detection of early chronic pancreatitis and AIP, risk stratification and application of risk-lowering strategies to prevent relapses in AIP or the development of recurrent (and possibly chronic) alcoholic pancreatitis and new evidence that antioxidants may have a modest effect on reducing the dominant symptom in chronic pancreatitis, abdominal pain.
DiMagno
Matthew J
MJ
Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA. mdimagno@umich.edu
DiMagno
Eugene P
EP
D000305:Adrenal Cortex Hormones; D000428:Alcohol Drinking / Q000009:adverse effects / Q000517:prevention & control; D000975:Antioxidants / Q000627:therapeutic use; D002766:Cholecystokinin; D003937:Diagnosis, Differential; D004724:Endoscopy; D005243:Feces / Q000201:enzymology; D005820:Genetic Testing; D006801:Humans; D010196:Pancreatic Elastase / Q000032:analysis; D010186:Pancreatic Function Tests; D050500:Pancreatitis, Chronic / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics
D000305:Adrenal Cortex Hormones; D000975:Antioxidants; D002766:Cholecystokinin; D010196:Pancreatic Elastase