Follow-up of Patients with Chronic Pancreatitis in Clinical Practice: How and What for?

Chronic pancreatitis (CP) is characterized by irreversible fibrosis of the pancreatic parenchyma that leads to a syndrome characterized by persistent pain and the metabolic derangements that arise from loss of the exocrine and endocrine functions of the gland. This chapter provides a guide to the diagnosis and routine management of patients with CP for the clinician treating patients with this condition. Pain is the cardinal symptom of CP, and yet the most difficult to assess and treat. Malnutrition is a common phenomenon in CP, especially among those with exocrine pancreatic insufficiency (EPI). Pancreatogenic or type 3c diabetes is a manifestation of CP, although its incidence is variable. Approximately 60-90% of patients with CP will develop EPI within 10-12 years from the diagnosis. While overt maldigestion is relatively simple to diagnose, EPI is also associated with more subtle and often elusive specific nutrient deficiencies, such as zinc, magnesium, prealbumin, and retinol-binding protein.