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. 2021 Feb 1;72(2):324-340.
doi: 10.1097/MPG.0000000000003001.

Medical Management of Chronic Pancreatitis in Children: A Position Paper by the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Pancreas Committee

A Jay Freeman  1 , Asim Maqbool  2 , Melena D Bellin  3 , Kenneth R Goldschneider  4 , Amit S Grover  5 , Cheryl Hartzell  6 , Travis L Piester  7 , Flora Szabo  8 , Bridget Dowd Kiernan  2 , Racha Khalaf  9 , Rakesh Kumar  10 , Mirta Rios  11 , Sohail Z Husain  12 , Veronique D Morinville  13 , Maisam Abu-El-Haija  14
Affiliations

Medical Management of Chronic Pancreatitis in Children: A Position Paper by the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Pancreas Committee

A Jay Freeman et al. J Pediatr Gastroenterol Nutr. .

Abstract

This position paper summarizes the current understanding of the medical management of chronic pancreatitis (CP) in children in light of the existing medical literature, incorporating recent advances in understanding of nutrition, pain, lifestyle considerations, and sequelae of CP. This article complements and is intended to integrate with parallel position papers on endoscopic and surgical aspects of CP in children. Concepts and controversies related to pancreatic enzyme replacement therapy (PERT), the use of antioxidants and other CP medical therapies are also reviewed. Highlights include inclusion of tools for medical decision-making for PERT, CP-related diabetes, and multimodal pain management (including an analgesia ladder). Gaps in our understanding of CP in children and avenues for further investigations are also reviewed.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

FIGURE 1.
FIGURE 1.
An example of an institutional clinical pathway for testing and diagnosing exocrine pancreatic insufficiency in children. Modified from Padula et al (18).
FIGURE 2.
FIGURE 2.
Proposed analgesic ladder for the treatment of pain in children with chronic pancreatitis. Graphics courtesy of Ms. Natalie Alexander. Nonpharmacologic pain care is assumed to be provided at all points in the ascension of analgesic potency.
See this image and copyright information in PMC

Comment in

References

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