title: Management of alcohol use disorders in patients with chronic pancreatitis.
abstract: BACKGROUND
  The outcome of treatment for patients with chronic pancreatitis may be improved by multidisciplinary management.
  
  
  OBJECTIVE
  To study patients with chronic pancreatitis, especially regarding alcohol use, within a multi disciplinary program.
  
  
  METHODS
  Prospective assessment at baseline and follow-up of alcohol use disorders using DSM-IV criteria, AUDIT score, interview-based quantification of alcohol intake and the biomarker for alcohol use s-CDT in patients referred because of chronic pancreatitis together with retrospective classification with the M-ANNHEIM risk factor analysis and severity scoring for chronic pancreatitis.
  
  
  RESULTS
  Sixty patients (95%) of 63 consecutively included patients were classified as having chronic pancreatitis. Forty-four of these (73%) were available for follow-up evaluation, which took place after a minimum of 1 year (median 3 years). Alcohol consumption decreased at follow-up and no patients had ongoing alcohol dependence (P&lt;0.001) as compared to 10 (23%) at initial evaluation. Patients with harmful alcohol use (AUDIT score ≥8 points) and pathological s-CDT had a reduction in both parameters (P=0.004 and P=0.060, respectively). Pain score according to M-ANNHEIM was unchanged, whereas use of analgesics decreased (P=0.005).
  
  
  CONCLUSIONS
  This feasibility study of patients with chronic pancreatitis demonstrated that multidisciplinary management seems to give a positive and sustainable effect on alcohol abuse and may be a useful concept for optimal classification, selection and treatment of patients with chronic pancreatitis.
authors.affiliation: Karolinska University Hospital. Stockholm, Sweden.
authors.forename: Margareta B
authors.initials: MB
authors.lastname: Lang
authors.forename: Ralf
authors.initials: R
authors.lastname: Segersvärd
authors.forename: Måns
authors.initials: M
authors.lastname: Grundsten
authors.forename: Märta
authors.initials: M
authors.lastname: Segerdahl
authors.forename: Urban
authors.initials: U
authors.lastname: Arnelo
authors.forename: Johan
authors.initials: J
authors.lastname: Permert
authors.forename: Johan
authors.initials: J
authors.lastname: Franck
authors.forename: Matthias
authors.initials: M
authors.lastname: Löhr
authors.forename: Jon A
authors.initials: JA
authors.lastname: Tsai
mesh_terms: D000368:Aged; D019973:Alcohol-Related Disorders / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D050500:Pancreatitis, Chronic / Q000628:therapy*; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014168:Transferrin / Q000031:analogs & derivatives / Q000032:analysis
chemical_list: D014168:Transferrin; C056759:carbohydrate-deficient transferrin