Alcohol-related chronic exocrine pancreatic insufficiency: diagnosis and therapeutic management. A proposal for treatment by the Italian Association for the Study of the Pancreas (AISP) and the Italian Society of Alcohology (SIA).

Abstract:

:Current estimates of the prevalence of chronic pancreatitis, one of the most common causes of exocrine pancreatic insufficiency, are in the range of 3-10 per 100,000 people in many parts of the world. Alcohol consumption is a very important risk factor for exocrine pancreatic insufficiency and is involved in nearly half of all cases. The main hypothesis regarding the role of chronic alcohol consumption in pancreatitis is that there must be additional environmental or genetic risk factors involved for ongoing damage to occur. Treatment of patients with alcohol-related exocrine pancreatic insufficiency is complex, as the patient has two concomitant pathologies, alcohol-use disorder (AUD) and exocrine pancreatic insufficiency/chronic pancreatitis. Alcohol abstinence is the starting point for treatment, although even this along with the most advanced therapies allow only a slowdown in progression rather than restoration of function. This position paper of the Italian Association for the Study of the Pancreas and the Italian Society of Alcohology provides an overview of the pathogenesis of alcohol-related pancreatitis and discuss diagnostic issues. Treatment options for both exocrine pancreatic insufficiency/chronic pancreatitis (with a focus on pancreatic enzyme replacement therapy) and AUD (acamprosate, disulfiram, oral naltrexone, long-acting injectable naltrexone, sodium oxybate, nalmefene, baclofen, and psychosocial interventions) are also reviewed.

journal_name

Minerva Med

journal_title

Minerva medica

authors

Pezzilli R,Caputo F,Testino G,Patussi V,Greco G,Macciò L,Rossin MR,Mioni D,Balbinot P,Gandin C,Zanesini F,Frulloni L,Aricò S,Bottaro LC,Pellicano R,Scafato E,Italian Society of Alcohology (SIA).

doi

10.23736/S0026-4806.19.06043-9

subject

Has Abstract

pub_date

2019-10-01 00:00:00

pages

425-438

issue

5

eissn

0026-4806

issn

1827-1669

pii

S0026-4806.19.06043-9

journal_volume

110

pub_type

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