Chronic pancreatitis history and symptoms: Difference between revisions

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==History and Symptoms==
==History and Symptoms==
* Presentation depends upon dysfunction in any one of the following:
** Biliary tract obstruction; presenting as jaundice
** Exocrine dysfunction; presenting as malabsorption
** Endocrine dysfunction; presenting as diabetes
Patients with chronic pancreatitis usually present with:
Patients with chronic pancreatitis usually present with:
* Persistent [[abdominal pain]] with episodic flares may or may not be associated with food intake<ref name="pmid6706066">{{cite journal |vauthors=Ammann RW, Akovbiantz A, Largiader F, Schueler G |title=Course and outcome of chronic pancreatitis. Longitudinal study of a mixed medical-surgical series of 245 patients |journal=Gastroenterology |volume=86 |issue=5 Pt 1 |pages=820–8 |year=1984 |pmid=6706066 |doi= |url=}}</ref><ref name="pmid7792289">{{cite journal |vauthors=Lankisch PG, Seidensticker F, Löhr-Happe A, Otto J, Creutzfeldt W |title=The course of pain is the same in alcohol- and nonalcohol-induced chronic pancreatitis |journal=Pancreas |volume=10 |issue=4 |pages=338–41 |year=1995 |pmid=7792289 |doi= |url=}}</ref><ref name="pmid6706079">{{cite journal |vauthors=Warshaw AL |title=Pain in chronic pancreatitis. Patients, patience, and the impatient surgeon |journal=Gastroenterology |volume=86 |issue=5 Pt 1 |pages=987–9 |year=1984 |pmid=6706079 |doi= |url=}}</ref><ref name="pmid7926511">{{cite journal |vauthors=Layer P, Yamamoto H, Kalthoff L, Clain JE, Bakken LJ, DiMagno EP |title=The different courses of early- and late-onset idiopathic and alcoholic chronic pancreatitis |journal=Gastroenterology |volume=107 |issue=5 |pages=1481–7 |year=1994 |pmid=7926511 |doi= |url=}}</ref>.  Typical features of pain are:
* Persistent [[abdominal pain]] with episodic flares may or may not be associated with food intake<ref name="pmid6706066">{{cite journal |vauthors=Ammann RW, Akovbiantz A, Largiader F, Schueler G |title=Course and outcome of chronic pancreatitis. Longitudinal study of a mixed medical-surgical series of 245 patients |journal=Gastroenterology |volume=86 |issue=5 Pt 1 |pages=820–8 |year=1984 |pmid=6706066 |doi= |url=}}</ref><ref name="pmid7792289">{{cite journal |vauthors=Lankisch PG, Seidensticker F, Löhr-Happe A, Otto J, Creutzfeldt W |title=The course of pain is the same in alcohol- and nonalcohol-induced chronic pancreatitis |journal=Pancreas |volume=10 |issue=4 |pages=338–41 |year=1995 |pmid=7792289 |doi= |url=}}</ref><ref name="pmid6706079">{{cite journal |vauthors=Warshaw AL |title=Pain in chronic pancreatitis. Patients, patience, and the impatient surgeon |journal=Gastroenterology |volume=86 |issue=5 Pt 1 |pages=987–9 |year=1984 |pmid=6706079 |doi= |url=}}</ref><ref name="pmid7926511">{{cite journal |vauthors=Layer P, Yamamoto H, Kalthoff L, Clain JE, Bakken LJ, DiMagno EP |title=The different courses of early- and late-onset idiopathic and alcoholic chronic pancreatitis |journal=Gastroenterology |volume=107 |issue=5 |pages=1481–7 |year=1994 |pmid=7926511 |doi= |url=}}</ref>.  Typical features of pain are:

Revision as of 20:44, 8 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

History and Symptoms

  • Presentation depends upon dysfunction in any one of the following:
    • Biliary tract obstruction; presenting as jaundice
    • Exocrine dysfunction; presenting as malabsorption
    • Endocrine dysfunction; presenting as diabetes

Patients with chronic pancreatitis usually present with:

  • Persistent abdominal pain with episodic flares may or may not be associated with food intake[1][2][3][4]. Typical features of pain are:
    • Located in the epigastrium
    • Radiating to the back
    • May be associated with nausea and vomiting
    • Usually worse 15-30min after meal
    • Initially it occurs in discrete episodes but later on as the disease progresses, it changes to continuous-like pattern
  • Steatorrhea resulting from malabsorption of the fats in food (greasy, loose, very bad smelling stools that are difficult to flush away).[5][6][7]
  • Pancreatic diabetes[5][8][6]
  • Nausea
  • Weight loss

References

  1. Ammann RW, Akovbiantz A, Largiader F, Schueler G (1984). "Course and outcome of chronic pancreatitis. Longitudinal study of a mixed medical-surgical series of 245 patients". Gastroenterology. 86 (5 Pt 1): 820–8. PMID 6706066.
  2. Lankisch PG, Seidensticker F, Löhr-Happe A, Otto J, Creutzfeldt W (1995). "The course of pain is the same in alcohol- and nonalcohol-induced chronic pancreatitis". Pancreas. 10 (4): 338–41. PMID 7792289.
  3. Warshaw AL (1984). "Pain in chronic pancreatitis. Patients, patience, and the impatient surgeon". Gastroenterology. 86 (5 Pt 1): 987–9. PMID 6706079.
  4. Layer P, Yamamoto H, Kalthoff L, Clain JE, Bakken LJ, DiMagno EP (1994). "The different courses of early- and late-onset idiopathic and alcoholic chronic pancreatitis". Gastroenterology. 107 (5): 1481–7. PMID 7926511.
  5. 5.0 5.1 DiMagno EP, Go VL, Summerskill WH (1973). "Relations between pancreatic enzyme outputs and malabsorption in severe pancreatic insufficiency". N. Engl. J. Med. 288 (16): 813–5. doi:10.1056/NEJM197304192881603. PMID 4693931.
  6. 6.0 6.1 Mergener K, Baillie J (1997). "Chronic pancreatitis". Lancet. 350 (9088): 1379–85. doi:10.1016/S0140-6736(97)07332-7. PMID 9365465.
  7. Toskes PP, Hansell J, Cerda J, Deren JJ (1971). "Vitamin B 12 malabsorption in chronic pancreatic insufficiency". N. Engl. J. Med. 284 (12): 627–32. doi:10.1056/NEJM197103252841202. PMID 5547614.
  8. Malka D, Hammel P, Sauvanet A, Rufat P, O'Toole D, Bardet P, Belghiti J, Bernades P, Ruszniewski P, Lévy P (2000). "Risk factors for diabetes mellitus in chronic pancreatitis". Gastroenterology. 119 (5): 1324–32. PMID 11054391.


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