Chronic pancreatitis is a progressive fibroinflammatory disease that exists in large-duct (often with intraductal calculi) or small-duct form. In many patients this disease results from a complex mix of environmental (eg, alcohol, cigarettes, and occupational chemicals) and genetic factors (eg, mutation in a trypsin-controlling gene or the cystic fibrosis transmembrane conductance regulator); a few patients have hereditary or autoimmune disease. Pain in the form of recurrent attacks of pancreatitis (representing paralysis of apical exocytosis in acinar cells) or constant and disabling pain is usually the main symptom. Management of the pain is mainly empirical, involving potent analgesics, duct drainage by endoscopic or surgical means, and partial or total pancreatectomy. However, steroids rapidly reduce symptoms in patients with autoimmune pancreatitis, and micronutrient therapy to correct electrophilic stress is emerging as a promising treatment in the other patients. Steatorrhoea, diabetes, local complications, and psychosocial issues associated with the disease are additional therapeutic challenges.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/S0140-6736(10)61852-1 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Endoscopic Management of Benign Pancreaticobiliary Disorders.
J Clin Med
January 2025
Division of Gastroenterology and Hepatology, Center for Digestive Health, Virginia Mason, Franciscan Health, Seattle, WA 98101, USA.
Endoscopic management of benign pancreaticobiliary disorders encompasses a range of procedures designed to address complications in gallstone disease, choledocholithiasis, and pancreatic disorders. Acute cholecystitis is typically treated with cholecystectomy or percutaneous drainage (PT-GBD), but for high-risk or future surgical candidates, alternative decompression methods, such as endoscopic transpapillary gallbladder drainage (ETP-GBD), and endoscopic ultrasound (EUS)-guided gallbladder drainage (EUS-GBD), are effective. PT-GBD is associated with significant discomfort as well as variable adverse event rates.
View Article and Find Full Text PDFRisk factors associated with pain and pain relief in patients with chronic pancreatitis.
Postgrad Med J
January 2025
Department of Gastroenterology, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Shinan District, Qingdao 266075, China.
Background: Abdominal pain is one of the most prominent symptoms in patients with chronic pancreatitis (CP) and can manifest intermittently or persistently. The mechanism of pain is not yet clear, and no effective treatment is currently available. This study aimed to explore the risk factors for pain in patients with CP, which may provide new insights for developing effective pain control modalities.
View Article and Find Full Text PDFLong-Term Islet Graft Functional Assessments in More than 500 Patients Undergoing Total Pancreatectomy with Intraportal Islet Autotransplantation.
J Am Coll Surg
January 2025
Departments of Surgery, University of Minnesota Medical School Department of Pediatrics, University of Minnesota Medical School Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota.
Background: Total pancreatectomy and intraportal islet cell auto transplantation (TPIAT) is increasingly being offered to patients with refractory chronic pancreatitis. Understanding factors that impact islet function over time is critical.
Study Design: We evaluated factors associated with islet function over 12 years post TPIAT using mixed meal tolerance testing (MMTT).
Association between dietary mineral intake and new onset diabetes/pre-diabetes after chronic pancreatitis.
Front Nutr
January 2025
Department of Gastroenterology, The Affiliated Hospital to Qingdao University, Qingdao, China.
Background And Aims: As the main type of pancreatic diabetes, patients with new diabetes after chronic pancreatitis are often difficult to manage and have poor prognosis. This study aimed to figure out the association between dietary mineral intake and glucose metabolism with chronic pancreatitis.
Method: The study included 114 patients with chronic pancreatitis, who were grouped based on the sequence of onset for chronic pancreatitis and diabetes: normoglycaemia after chronic pancreatitis (NCP), type 2 diabetes (T2DM), and new-onset diabetes or pre-diabetes after chronic pancreatitis (NODCP).
Identification of a vimentin-expressing α-cell phenotype in CF and normal pancreas.
J Endocrinol
January 2025
J Shaw, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland.
Endocrine dysfunction and diabetes can develop secondary to fibrotic diseases within the pancreas including cystic fibrosis (CF). Phenotypic shift within epithelial cells has been recognised in association with pro-fibrotic signalling. We sought evidence of endocrine cell epithelial-to-mesenchymal transition in CF and non-CF pancreas.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!