Advances in the diagnosis and treatment of dyspepsia in chronic pancreatitis patients

Lianghao HU; Zhendong JIN

doi:10.3969/j.issn.1001-5256.2023.12.002

Volume 39 Issue 12

Dec. 2023

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Article Navigation > Journal of Clinical Hepatology > 2023 > 39(12): 2757-2762

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Advances in the diagnosis and treatment of dyspepsia in chronic pancreatitis patients

DOI: 10.3969/j.issn.1001-5256.2023.12.002

Lianghao HU,
Zhendong JIN^{,
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Department of Gastroenterology，The First Affiliated Hospital of Navy Medical University，Shanghai 200433，China

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Corresponding author: JIN Zhendong， zhendjin@126.com （ORCID： 0000-0003-1196-9047）
Received Date: 2023-09-03
Accepted Date: 2023-10-08
Published Date: 2023-12-12

Abstract

Abstract

Dyspepsia is a common group of clinical symptoms and can be classified into organic and functional dyspepsia. Patients with chronic pancreatitis （CP） often have the symptoms of dyspepsia such as fatty diarrhea， abdominal distention， and abdominal pain， and most patients have pancreatic exocrine insufficiency （PEI）， which belongs to organic dyspepsia. In clinical practice， the diagnosis of PEI and dyspepsia requires a comprehensive assessment of clinical manifestations， nutritional status， and pancreatic exocrine function， and an individualized treatment regimen should be developed based on such factors. However， some patients with normal exocrine function may have the symptoms of dyspepsia， and the diagnosis and treatment of such patients are still difficulties in clinical practice. This article reviews the advances in the diagnosis and treatment of dyspepsia in CP patients.
- Pancreatitis， Chronic,
- Exocrine Pancreatic Insufficiency,
- Dyspepsia,
- Diagnosis,
- Therapeutics

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References(40)

References

[1]	FORD AC, MAHADEVA S, CARBONE MF, et al. Functional dyspepsia[J]. Lancet, 2020, 396( 10263): 1689- 1702. DOI: 10.1016/S0140-6736(20)30469-4.
[2]	VEGE SS, CHARI ST. Chronic pancreatitis[J]. N Engl J Med, 2022, 386( 9): 869- 878. DOI: 10.1056/nejmcp1809396.
[3]	LIU Y, YIN XY, WANG D, et al. Risk factor analysis and nomogram development for steatorrhea in idiopathic chronic pancreatitis[J]. J Dig Dis, 2022, 23( 5-6): 331- 340. DOI: 10.1111/1751-2980.13102.
[4]	HAO L, WANG LS, LIU Y, et al. The different course of alcoholic and idiopathic chronic pancreatitis: A long-term study of 2, 037 patients[J]. PLoS One, 2018, 13( 6): e0198365. DOI: 10.1371/journal.pone.0198365.
[5]	CAMPAGNOLA P, de PRETIS N, ZORZI A, et al. Chronic pancreatitis and nutritional support[J]. Best Pract Res Clin Gastroenterol, 2023, 62-63: 101823. DOI: 10.1016/j.bpg.2023.101823.
[6]	QU AIN, BASHIR Y, KELLEHER L, et al. Dietary intake in patients with chronic pancreatitis: A systematic review and meta-analysis[J]. World J Gastroenterol, 2021, 27( 34): 5775- 5792. DOI: 10.3748/wjg.v27.i34.5775.
[7]	ERCHINGER F, ENGJOM T, DIMCEVSKI G, et al. Exocrine pancreas insufficiency in chronic pancreatitis-Risk factors and associations with complications. A multicentre study of 1869 patients[J]. Pancreatology, 2022, 22( 3): 374- 380. DOI: 10.1016/j.pan.2022.02.003.
[8]	CAÑAMARES-ORBÍS P, GARCÍA-RAYADO G, ALFARO-ALMAJANO E. Nutritional support in pancreatic diseases[J]. Nutrients, 2022, 14( 21): 4570. DOI: 10.3390/nu14214570.
[9]	MARTÍNEZ-MONEO E, STIGLIANO S, HEDSTRÖM A, et al. Deficiency of fat-soluble vitamins in chronic pancreatitis: A systematic review and meta-analysis[J]. Pancreatology, 2016, 16( 6): 988- 994. DOI: 10.1016/j.pan.2016.09.008.
[10]	HOOGENBOOM SA, LEKKERKERKER SJ, FOCKENS P, et al. Systematic review and meta-analysis on the prevalence of vitamin D deficiency in patients with chronic pancreatitis[J]. Pancreatology, 2016, 16( 5): 800- 806. DOI: 10.1016/j.pan.2016.07.010.
[11]	LINDKVIST B, DOMÍNGUEZ-MUÑOZ JE, LUACES-REGUEIRA M, et al. Serum nutritional markers for prediction of pancreatic exocrine insufficiency in chronic pancreatitis[J]. Pancreatology, 2012, 12( 4): 305- 310. DOI: 10.1016/j.pan.2012.04.006.
[12]	VUJASINOVIC M, HEDSTRÖM A, MAISONNEUVE P, et al. Zinc deficiency in patients with chronic pancreatitis[J]. World J Gastroenterol, 2019, 25( 5): 600- 607. DOI: 10.3748/wjg.v25.i5.600.
[13]	HART PA, YADAV D, LI L, et al. High prevalence of osteopathy in chronic pancreatitis: A cross-sectional analysis from the PROCEED study[J]. Clin Gastroenterol Hepatol, 2022, 20( 9): 2005- 2013. DOI: 10.1016/j.cgh.2021.09.026.
[14]	KUAN LL, DENNISON AR, GARCEA G. Prevalence and impact of sarcopenia in chronic pancreatitis: A review of the literature[J]. World J Surg, 2021, 45( 2): 590- 597. DOI: 10.1007/s00268-020-05828-0.
[15]	de la IGLESIA D, VALLEJO-SENRA N, LÓPEZ-LÓPEZ A, et al. Pancreatic exocrine insufficiency and cardiovascular risk in patients with chronic pancreatitis: A prospective, longitudinal cohort study[J]. J Gastroenterol Hepatol, 2019, 34( 1): 277- 283. DOI: 10.1111/jgh.14460.
[16]	CARNIE LE, LAMARCA A, MCNAMARA MG, et al. The assessment of pancreatic exocrine function in patients with inoperable pancreatic cancer: In need of a new gold-standard[J]. Pancreatology, 2020, 20( 4): 668- 675. DOI: 10.1016/j.pan.2020.03.020.
[17]	SWENSSON J, ZAHEER A, CONWELL D, et al. Secretin-enhanced MRCP: How and why- AJR expert panel narrative review[J]. AJR Am J Roentgenol, 2021, 216( 5): 1139- 1149. DOI: 10.2214/AJR.20.24857.
[18]	MIYAKE H, SAKAGAMI J, YASUDA H, et al. Association of fatty pancreas with pancreatic endocrine and exocrine function[J]. PLoS One, 2018, 13( 12): e0209448. DOI: 10.1371/journal.pone.0209448.
[19]	DIÉGUEZ-CASTILLO C, JIMÉNEZ-LUNA C, PRADOS J, et al. State of the art in exocrine pancreatic insufficiency[J]. Medicina, 2020, 56( 10): 523. DOI: 10.3390/medicina56100523.
[20]	PHILLIPS ME, HOPPER AD, LEEDS JS, et al. Consensus for the management of pancreatic exocrine insufficiency: UK practical guidelines[J]. BMJ Open Gastroenterol, 2021, 8( 1): e000643. DOI: 10.1136/bmjgast-2021-000643.
[21]	VANGA RR, TANSEL A, SIDIQ S, et al. Diagnostic performance of measurement of fecal elastase-1 in detection of exocrine pancreatic insufficiency: Systematic review and meta-analysis[J]. Clin Gastroenterol Hepatol, 2018, 16( 8): 1220- 1228. DOI: 10.1016/j.cgh.2018.01.027.
[22]	GONZÁLEZ-SÁNCHEZ V, AMRANI R, GONZÁLEZ V, et al. Diagnosis of exocrine pancreatic insufficiency in chronic pancreatitis: ¹³C-Mixed Triglyceride Breath Test versus Fecal Elastase[J]. Pancreatology, 2017, 17( 4): 580- 585. DOI: 10.1016/j.pan.2017.03.002.
[23]	DOMÍNGUEZ-MUÑOZ JE, de la IGLESIA-GARCÍA D, NIETO-GARCÍA L, et al. Endoscopic pancreatic drainage improves exocrine pancreatic function in patients with unresectable pancreatic cancer: A double-blind, prospective, randomized, single-center, interventional study[J]. Pancreas, 2021, 50( 5): 679- 684. DOI: 10.1097/MPA.0000000000001817.
[24]	de la IGLESIA-GARCÍA D, HUANG W, SZATMARY P, et al. Efficacy of pancreatic enzyme replacement therapy in chronic pancreatitis: Systematic review and meta-analysis[J]. Gut, 2017, 66( 8): 1354- 1355. DOI: 10.1136/gutjnl-2016-312529.
[25]	DOMINGUEZ-MUNOZ JE, DREWES AM, LINDKVIST B, et al. Recommendations from the United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis[J]. Pancreatology, 2018, 18( 8): 847- 854. DOI: 10.1016/j.pan.2018.09.016.
[26]	GARDNER TB, ADLER DG, FORSMARK CE, et al. ACG clinical guideline: Chronic pancreatitis[J]. Am J Gastroenterol, 2020, 115( 3): 322- 339. DOI: 10.14309/ajg.0000000000000535.
[27]	Special Committee on Chronic Pancreatitis, Pancreatic Disease Specialized Committee, Chinese Medical Doctor Association. Standards for the diagnosis and treatment of pancreatic exocrine insufficiency(2018, Guangzhou)[J]. J Clin Hepatol, 2019, 35( 2): 294- 298. DOI: 10.3969/j.issn.1001-5256.2019.02.010. 中国医师协会胰腺病专业委员会慢性胰腺炎专委会. 胰腺外分泌功能不全诊治规范(2018,广州)[J]. 临床肝胆病杂志, 2019, 35( 2): 294- 298. DOI: 10.3969/j.issn.1001-5256.2019.02.010.
[28]	Working Party of the Australasian Pancreatic Club, SMITH RC, SMITH SF, et al. Summary and recommendations from the Australasian guidelines for the management of pancreatic exocrine insufficiency[J]. Pancreatology, 2016, 16( 2): 164- 180. DOI: 10.1016/j.pan.2015.12.006.
[29]	DOMÍNGUEZ-MUÑOZ JE, IGLESIAS-GARCÍA J, IGLESIAS-REY M, et al. Effect of the administration schedule on the therapeutic efficacy of oral pancreatic enzyme supplements in patients with exocrine pancreatic insufficiency: A randomized, three-way crossover study[J]. Aliment Pharmacol Ther, 2005, 21( 8): 993- 1000. DOI: 10.1111/j.1365-2036.2005.02390.x.
[30]	ERCHINGER F, TJORA E, NORDAAS IK, et al. Pancreatic enzyme treatment in chronic pancreatitis: Quality of management and adherence to guidelines-a cross-sectional observational study[J]. United European Gastroenterol J, 2022, 10( 8): 844- 853. DOI: 10.1002/ueg2.12276.
[31]	SERÓN-ARBELOA C, LABARTA-MONZÓN L, PUZO-FONCILLAS J, et al. Malnutrition screening and assessment[J]. Nutrients, 2022, 14( 12): 2392. DOI: 10.3390/nu14122392.
[32]	SANDER-STRUCKMEIER S, BECKMANN K, JANSSEN-VAN SOLINGEN G, et al. Retrospective analysis to investigate the effect of concomitant use of gastric acid-suppressing drugs on the efficacy and safety of pancrelipase/pancreatin(CREON^®) in patients with pancreatic exocrine insufficiency[J]. Pancreas, 2013, 42( 6): 983- 989. DOI: 10.1097/MPA.0b013e31828784ef.
[33]	TALLEY NJ, HOLTMANN G, NGUYEN QN, et al. Undiagnosed pancreatic exocrine insufficiency and chronic pancreatitis in functional GI disorder patients with diarrhea or abdominal pain[J]. J Gastroenterol Hepatol, 2017, 32( 11): 1813- 1817. DOI: 10.1111/jgh.13791.
[34]	FORD AC, MARWAHA A, SOOD R, et al. Global prevalence of, and risk factors for, uninvestigated dyspepsia: A meta-analysis[J]. Gut, 2015, 64( 7): 1049- 1057. DOI: 10.1136/gutjnl-2014-307843.
[35]	ARVANITAKIS M, OCKENGA J, BEZMAREVIC M, et al. ESPEN guideline on clinical nutrition in acute and chronic pancreatitis[J]. Clin Nutr, 2020, 39( 3): 612- 631. DOI: 10.1016/j.clnu.2020.01.004.
[36]	MADRO A. Malnutrition in chronic pancreatitis: Causes, assessment methods, and therapeutic management[J]. Can J Gastroenterol Hepatol, 2020, 2020: 8875487. DOI: 10.1155/2020/8875487.
[37]	FORD AC, MOAYYEDI P, BLACK CJ, et al. Systematic review and network meta-analysis: Efficacy of drugs for functional dyspepsia[J]. Aliment Pharmacol Ther, 2021, 53( 1): 8- 21. DOI: 10.1111/apt.16072.
[38]	BLACK CJ, PAINE PA, AGRAWAL A, et al. British Society of Gastroenterology guidelines on the management of functional dyspepsia[J]. Gut, 2022, 71( 9): 1697- 1723. DOI: 10.1136/gutjnl-2022-327737.
[39]	FORD AC, TSIPOTIS E, YUAN YH, et al. Efficacy of Helicobacter pylori eradication therapy for functional dyspepsia: Updated systematic review and meta-analysis[J]. Gut, 2022. DOI: 10.1136/gutjnl-2021-326583.[ Online ahead of print]
[40]	SAYUK GS, GYAWALI CP. Functional dyspepsia: Diagnostic and therapeutic approaches[J]. Drugs, 2020, 80( 13): 1319- 1336. DOI: 10.1007/s40265-020-01362-4.

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Advances in the diagnosis and treatment of dyspepsia in chronic pancreatitis patients

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Advances in the diagnosis and treatment of dyspepsia in chronic pancreatitis patients

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