Chronic pancreatitis

Curr Opin Gastroenterol. 2009 Sep;25(5):454-9. doi: 10.1097/MOG.0b013e32832e1600.

Abstract

Purpose of review: We review important new clinical observations in chronic pancreatitis made in the last year.

Recent findings: 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.

Summary: 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.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones
  • Alcohol Drinking / adverse effects
  • Alcohol Drinking / prevention & control
  • Antioxidants / therapeutic use
  • Cholecystokinin
  • Diagnosis, Differential
  • Endoscopy
  • Feces / enzymology
  • Genetic Testing
  • Humans
  • Pancreatic Elastase / analysis
  • Pancreatic Function Tests
  • Pancreatitis, Chronic / diagnosis*
  • Pancreatitis, Chronic / drug therapy
  • Pancreatitis, Chronic / genetics

Substances

  • Adrenal Cortex Hormones
  • Antioxidants
  • Cholecystokinin
  • Pancreatic Elastase