ABSTRACT
The Russian consensus on exo- and endocrine pancreatic insufficiency after surgical treatment was prepared on the initiative of the Russian "Pancreatic Club" on the Delphi method. His goal was to clarify and consolidate the opinions of specialists on the most relevant issues of diagnosis and treatment of exo- and endocrine insufficiency after surgical interventions on the pancreas. An interdisciplinary approach is provided by the participation of leading gastroenterologists and surgeons.
Subject(s)
Consensus , Exocrine Pancreatic Insufficiency , Pancreas/surgery , Blood Glucose/analysis , Exocrine Pancreatic Insufficiency/diagnosis , Exocrine Pancreatic Insufficiency/etiology , Exocrine Pancreatic Insufficiency/therapy , Feces/chemistry , Glycated Hemoglobin/analysis , Hormone Replacement Therapy/methods , Lipase/therapeutic use , Nutritional Status , Pancreas/enzymology , Pancreas/physiopathology , Pancreatectomy , Pancreatic Elastase/analysis , RussiaABSTRACT
The article reflects the main positions of the latest Russian and pan-European clinical recommendations on the diagnosis and treatment of chronic pancreatitis (CP), devoted to the pharmacotherapy of this disease. The main objectives of pharmacotherapy for CP are to reduce or arrest pain abdominal syndrome and prevent or compensate for functional pancreatic insufficiency.
Subject(s)
Abdominal Pain/drug therapy , Enzyme Replacement Therapy/methods , Exocrine Pancreatic Insufficiency/drug therapy , Pancreatitis, Chronic/drug therapy , Abdominal Pain/complications , Analgesics/administration & dosage , Analgesics/therapeutic use , Antioxidants/administration & dosage , Antioxidants/therapeutic use , Exocrine Pancreatic Insufficiency/complications , Humans , Pancreatitis, Chronic/complications , Practice Guidelines as Topic , Quality of Life , Treatment OutcomeABSTRACT
THE AIM OF THE STUDY: to conduct a comprehensive assessment of features of combined course NASH and functional constipation using laboratory parameters, the data of instrumental methods, indicators of quality of life in comparison with patients with Nash without proven pathology of the intestine. MATERIALS AND METHODS: In the cross-sectional comparative study involving 102 patients with NASH, among which identified patients with functional constipation, there were formed two groups: study group (patients with NASH and functional constipation) and comparison group (patients with NASH without pathology of the intestine). All patients underwent a comprehensive assessment of laboratory data (markers of cytolysis, cholestasis, lipid and carbohydrate metabolism), results of instrumental methods (hydrogen breath test), quality of life (questionnaire SF-36). RESULTS: All patients with NASH, regardless of the presence of functional bowel pathology was characterized by hyperlipidemia with a tendency to lower HDL and raise LDL with normal levels of triglycerides, fasting hyperglycemia, increased postprandial glucose, glycated hemoglobin and HOMA--IR higher than normal values and the availability of the SIBO. NASH is often associated with functional constipation (68.6%). Patients with functional constipation and NASH have a significantly higher average level of ALT (127.3 ± 58.4 U/I in the control group and to 103.5 ± 74.6 U/I in the comparison group, p = 0.02), more frequent association with the SIBO (65.7% in the main group opposed to 43.7% in the comparison group, p = 0.014) and a lower quality of life compared with patients without pathology of the intestine. CONCLUSION: NASH has frequent association with functional constipation, worsens its course, resulting in a significant increase in the level of the marker of cytolysis (ALT), the more expressed SIBO and a palpable decline in the quality of life of patients, therefore the impaired intestinal function in these patients requires close attention.
