만성췌장염의 내과적 치료

Abstract

Chronic pancreatitis is an inflammatory disease characterized by the progressive destruction of pancreatic tissue and resulting in pancreatic exocrine and endocrine insufficiency. Although a lot of efforts have been made in managing chronic pancreatitis, treatment of chronic pancreatitis is still challenging and remains mostly empirical. Medical treatment of chronic pancreatitis focuses on chronic abdominal pain, pancreatic exocrine insufficiency and also pancreatic endocrine insufficiency. Chronic disabling abdominal pain is the main symptom of chronic pancreatitis, which could be managed by analgesics and non-enteric coated pancreatic enzymes as well as adjunctive agents such as antidepressants, duolexitine and pregabalin. Pancreatic exocrine insufficiency is commonly associated with weight loss, steatorrhea and malnutrition. Adequate pancreatic enzyme replacement therapy can significantly improve not only exocrine insufficiency related symptoms but also nutritional status. Several problems affecting the efficacy of pancreatic enzyme replacement can be avoided by the use of enteric-coated enzyme microspheres with or without proton pump inhibitors. (Korean J Med 2012;83:18-28)