title: Relationship between pain and plasma amino acid levels in chronic pancreatitis.
abstract: OBJECTIVE
  Our aim was to investigate the relationship between imbalances of plasma amino acids and pain in chronic pancreatitis (CP).
  
  
  METHODS
  Thirty patients with alcoholic CP in an exocrine-insufficient state were examined. We divided them between diet and control group. Diet group ingested 80 g/300 kcal of the elemental diet "Elental®". This diet of 300 kcal/day was administered for two months. Selected clinical and laboratory values were compared between both groups before and after diet. Pain was observed and compared using a visual analog scale (VAS).
  
  
  RESULTS
  There was no significant difference in the BMI between both groups before and after diet. The serum albumin level in diet group after diet was significantly higher than in control group (P=0.036). There was no significant difference in HbA1c between both groups before and after diet. The total amino acid concentration was significantly higher in diet group after diet than in control group (P=0.033). The concentrations of serum histidine and methionine in diet group after diet were significantly higher than in control group (histidine, P=0.022; methionine, P=0.026). The concentration of serum glutamate in diet group after diet was significantly lower than in control group (P=0.027). The balance of amino acids in diet group was normalized after the Elental® was ingested. The VAS score was significantly lower in diet group after diet than in control group (P=0.018).
  
  
  CONCLUSIONS
  These amino acid levels and pancreatic pain were improved by the elemental diet. The pancreatic pain may be related to these amino acid imbalances.
authors: Tokai University School of Medicine. Isehara, Japan. y711kawa@is.icc.u-tokai.ac.jp.
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