The Influence of Granular Pancreatin upon Endocrine and Exocrine Pancreatic Function During Convalescence from Acute Pancreatitis
In the majority of cases, acute pancreatitis is a short-lived illness with rapid resolution of symptoms, signs and biochemical abnormalities. Nevertheless, there is evidence that even after relatively mild attacks of acute pancreatitis, disturbances of exocrine function may persist for several months (Mitchell et al. 1979). Some patients suffer recurrent attacks of mild acute pancreatitis, recurrent pain being particularly likely to occur on the resumption of normal eating during convalescence from an attack. One of the principles of therapeutics is to rest the organ that is diseased, and this is applied to the management of acute pancreatitis by the withdrawal of food and the institution of nasogastric aspiration to minimise stimuli which result in the secretion of pancreatic juice. We reasoned that it might help to extend the period of pancreatic rest into the convalescent phase of the attack in the hope that it could lead to more rapid recovery of exocrine function and that it might prevent recurrent attacks of pancreatitis when eating recommenced. Accordingly, we carried out a randomised placebo-controlled trial of granular pancreatin (Creon) during the convalescent stage of acute pancreatitis, in order to investigate its influence upon exocrine function, endocrine function and abdominal pain.
KeywordsAcute Pancreatitis Chronic Pancreatitis Oral Glucose Tolerance Test Pancreatic Juice Pancreatic Function
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Adler G, Müllenhoff A, Bozkurt T, Göke B, Koop I, Arnold R (1988) Comparison of the effect of single and repeated administrations of a protease inhibitor (Camostate) on pancreatic secretion in man. Scand J Gastroenterol 23:158–162PubMedCrossRefGoogle Scholar
Dlugosz J, Fölsch UR, Czajkowski A, Gabryelewicz A (1988) Feedback regulation of stimulated pancreatic enzyme secretion during intraduodenal perfusion of trypsin in man. Eur J Clin Invest 18:267–272PubMedCrossRefGoogle Scholar
Hotz J, Ho SB, Go VLW, DiMagno EP (1983) Short term inhibition of duodenal tryptic activity does not affect human pancreatic, biliary or gastric function. J Lab Clin Med 101:488–495PubMedGoogle Scholar
Mitchell CJ, Humphrey CS, Bullen EW, Kelleher J (1979) The diagnostic value of oral pancreatic function test. Scand J Gastroenterol 14:183–187PubMedCrossRefGoogle Scholar
Mitchell CJ, Playforth MJ, Kelleher J, McMahon MJ (1983) Functional recovery of the exocrine pancreas after acute pancreatitis. Scand J Gastroenterol 18:5–8PubMedCrossRefGoogle Scholar
Owyang C, May D, Louie DS (1986) Trypsin suppression of pancreatic enzyme secretion. Gastroenterology 91:637–643PubMedGoogle Scholar
Slaff JI, Jacobson D, Tillman CR, Curington C, Toskes P (1984) Protease-specific suppression of pancreatic exocrine secretion. Gastroenterology 87:44–52PubMedGoogle Scholar
Slaff JI, Wolfe MM, Toskes PP (1985) Elevated fasting cholecystokinin levels in pancreatic exocrine impairment: evidence to support feedback regulation. J Lab Clin Med 105:282–283PubMedGoogle Scholar
Smith HW, Finkelstein N, Aluminosa L, Crawford B, Graber M (1945) The renal clearance of substitute hippuric acid derivatives and other aromatic acids in dog and man. J Clin Invest 24:388–394PubMedCrossRefGoogle Scholar
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