How is chronic pancreatitis treated?

With pain relief, exocrine replacement (pancreatic enzyme supplements such as pancreatin, with fat-soluble vitamins), and endocrine replacement (insulin) for diabetes, alongside alcohol abstinence. Endoscopic or surgical intervention is used for duct strictures, stones, or pseudocysts.

Clinical relevance. Enzyme and insulin replacement plus pain control and abstinence manage the consequences of chronic pancreatitis.

More Detail

Treatment of chronic pancreatitis

Treatment relieves pain and replaces lost exocrine and endocrine function.

Symptom and function management

• Pain relief (analgesic ladder; neuropathic agents; coeliac plexus block in some).
• Exocrine replacement: pancreatic enzyme supplementation (pancreatin) with meals (and elemental diets), plus fat-soluble vitamin supplementation.
• Endocrine replacement: insulin for diabetes.

Cause and lifestyle

• Alcohol abstinence (and smoking cessation) - essential.

Interventional/surgical

• Endoscopic therapy (stenting, stone removal) or surgery (drainage procedures, resection) for duct strictures, stones, pseudocysts, or intractable pain.