title: Effects of oral ingestion of the elemental diet in patients with painful chronic pancreatitis in the real-life setting in Japan.
abstract: OBJECTIVE
  Most patients with chronic pancreatitis develop intractable abdominal pain and malnutrition. A low-fat diet is one of the options used to manage intractable abdominal pain and malnutrition. However, few reports have examined the pain-suppression effect. To investigate the effects of oral ingestion of a low-fat elemental diet composed of purified amino acids on pain and nutritional status in patients with chronic pancreatitis, a multicenter prospective study was conducted.
  
  
  METHODS
  Patients with chronic pancreatitis with symptoms of abdominal pain were enrolled. In addition to meals, patients ingested a low-fat elemental diet composed of purified amino acids for 12 weeks. Before and after treatment, patients were asked to indicate their pain grade using a 100-mm horizontal visual analog scale, and nutritional indices, including body mass index and blood levels of pancreatic enzymes, were measured.
  
  
  RESULTS
  A total of 596 patients were eligible for analysis. Marked pain reduction was observed with a significant decrease of the mean visual analog scale score by 32.9 mm from 52.9 mm after 12 weeks (P < 0.001). There were also significant improvements in nutritional indices.
  
  
  CONCLUSIONS
  An oral low-fat elemental diet composed of purified amino acids, which requires no special treatment procedures, may improve patients' quality of life.
authors.affiliation: From the *Otsu Municipal Hospital, Shiga; †Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto; and ‡Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Japan.
authors.forename: Keisho
authors.initials: K
authors.lastname: Kataoka
authors.forename: Junichi
authors.initials: J
authors.lastname: Sakagami
authors.forename: Morihisa
authors.initials: M
authors.lastname: Hirota
authors.forename: Atsushi
authors.initials: A
authors.lastname: Masamune
authors.forename: Tooru
authors.initials: T
authors.lastname: Shimosegawa
mesh_terms: D015746:Abdominal Pain / Q000178:diet therapy* / Q000209:etiology; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D044466:Asian People; D003920:Diabetes Mellitus / Q000209:etiology; D003967:Diarrhea / Q000209:etiology; D018752:Diet, Fat-Restricted / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005526:Food, Formulated; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology; D007564:Japan; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010147:Pain Measurement; D050500:Pancreatitis, Chronic / Q000150:complications* / Q000208:ethnology; D011446:Prospective Studies; D016896:Treatment Outcome