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Chronic Pancreatitis

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Pancreas and Biliary Disease

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Abstract

Chronic pancreatitis (CP) is characterized by recurrent intractable pain, exocrine insufficiency, and endocrine dysfunction that result from progressive inflammation and fibrosis of the pancreas. CP is associated with several risk factors including alcohol, smoking, and genetic polymorphisms. Pain in CP is multifactorial and can result from mechanisms such as nociception, pancreatic and central neuropathy and neuroplasticity. The determinants of pain include ductal and interstitial hypertension from calculi and/or strictures, tissue ischemia, oxidative stress, to name a few. Pancreatic fibrosis is mediated by activated pancreatic stellate cells. CP requires a multimodal therapeutic approach that includes endotherapy and/or surgery for symptomatic calculi, stricture and local complications such as symptomatic pseudocysts, biliary obstruction and gastric outlet obstruction. Medical modalities for long term pain management include antioxidants and neuromodulators such as pregabalin. Pancreatic exocrine insufficiency should be managed with the right dosage of enzyme supplements complemented by appropriate nutritional support.

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Authors and Affiliations

  1. Asian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500082, Telangana, India

    Rupjyoti Talukdar & D. Nageshwar Reddy

  2. Asian Healthcare Foundation, Hyderabad, 500082, Telangana, India

    Rupjyoti Talukdar

Authors
  1. Rupjyoti Talukdar
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  2. D. Nageshwar Reddy
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Correspondence to D. Nageshwar Reddy .

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Editors and Affiliations

  1. Division of Gastroenterology & Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

    Kulwinder Dua

  2. Division of Gastroenterology & Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

    Reza Shaker

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© 2016 Springer International Publishing Switzerland

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Talukdar, R., Reddy, D.N. (2016). Chronic Pancreatitis. In: Dua, K., Shaker, R. (eds) Pancreas and Biliary Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-28089-9_3

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  • DOI: https://doi.org/10.1007/978-3-319-28089-9_3

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