The Influence of Granular Pancreatin upon Endocrine and Exocrine Pancreatic Function During Convalescence from Acute Pancreatitis

Abstract

In the majority of cases, acute pancreatitis is a short-lived illness with rapid resolution of symptoms, signs and biochemical abnormalities. Nevertheless, there is evidence that even after relatively mild attacks of acute pancreatitis, disturbances of exocrine function may persist for several months (Mitchell et al. 1979). Some patients suffer recurrent attacks of mild acute pancreatitis, recurrent pain being particularly likely to occur on the resumption of normal eating during convalescence from an attack. One of the principles of therapeutics is to rest the organ that is diseased, and this is applied to the management of acute pancreatitis by the withdrawal of food and the institution of nasogastric aspiration to minimise stimuli which result in the secretion of pancreatic juice. We reasoned that it might help to extend the period of pancreatic rest into the convalescent phase of the attack in the hope that it could lead to more rapid recovery of exocrine function and that it might prevent recurrent attacks of pancreatitis when eating recommenced. Accordingly, we carried out a randomised placebo-controlled trial of granular pancreatin (Creon) during the convalescent stage of acute pancreatitis, in order to investigate its influence upon exocrine function, endocrine function and abdominal pain.