Irritable Bowel Syndrome (IBS) is a prevalent functional gastrointestinal disorder that significantly impacts the quality of life and the healthcare system. Beyond well-established symptoms such as recurrent abdominal pain and altered bowel habits, emerging evidence highlights a crucial yet underexplored aspect of cognitive dysfunction in patients suffering from IBS. This review aims to investigate the potential mechanisms linking IBS to cognitive dysfunction, emphasizing the role of the gut-brain axis and its biological and psychosocial determinants. A literature review was conducted using major medical databases, including Pubmed and Scopus, to identify relevant studies published in the last decade, focusing on clinical and experimental research assessing cognitive impairment in IBS patients. The review underscores the need for increased clinical recognition of cognitive dysfunction in IBS by highlighting the cognitive dysfunction in IBS patients with a focus on pathogenesis from disturbances in gut microbiota, inflammation, altered neurotransmitter levels, and psychological stress with various treatment modalities targeting these pathways, including probiotics, cognitive-behavioural therapy, and pharmacological interventions, showing promising results in mitigating cognitive symptoms.

Inflammatory bowel disease (IBD) is a chronic recurrent gastrointestinal disease that seriously affects the quality of life of patients around the world. It is characterized by recurrent abdominal pain, diarrhea, and mucous bloody stools. There is an urgent need for more accurate diagnosis and effective treatment of IBD. Accumulated evidence suggests that gut microbiota plays an important role in the occurrence and development of gut inflammation. However, most studies on the role of gut microbiota in IBD have focused on bacteria, while fungal microorganisms have been neglected. Fungal dysbiosis can activate the host protective immune pathway related to the integrity of the epithelial barrier and release a variety of pro-inflammatory cytokines to trigger the inflammatory response. Dectin-1, CARD9, and IL-17 signaling pathways may be immune drivers of fungal dysbacteriosis in the development of IBD. In addition, fungal-bacterial interactions and fungal-derived metabolites also play an important role. Based on this information, we explored new strategies for IBD treatment targeting the intestinal fungal group and its metabolites, such as fungal probiotics, antifungal drugs, diet therapy, and fecal microbiota transplantation (FMT). This review aims to summarize the fungal dysbiosis and pathogenesis of IBD, and provide new insights and directions for further research in this emerging field.

Postpartum uterine necrosis is a rare and serious complication. The uterine tissue becomes devascularized and then causes endometrial necrosis and even myometrial necrosis, usually combing with uterine infection. To clear the infection, hysterectomy was performed in the majority of uterine necrosis cases. We reported a case of a 26-year-old patient underwent a cesarean section after failure induction of labor with the full dilatation of cervix. The B-Lynch compression suture was performed to avoid persistent haemorrhage. The patient presented with recurrent fever, abdominal pain and vaginal discharge. The computed tomography scan revealed uterine empyema and uterine perforation of the anterior wall. The broad spectrum antibiotics were given to treat with infection. An irregularly shaped prolapse from the vagina was noted on the fifty-fourth day postpartum. Transvaginal debridement was performed and necrotizing tissues weighted about 100 g was removed. The pathological findings revealed degeneration and necrosis of the uterine muscle and fibrinoid exudation. Postpartum uterine necrosis is a rare condition that can lead to life-threatening complications and the most treatment option is the surgery of hysterectomy. As cases of partial uterine necrosis with symptom of endometrial prolapse, treated with direct appropriate antibiotic therapy, removing the necrotizing tissue that reserved the uterine may be a selective option.

Background: Irritable Bowel Syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by recurrent abdominal pain and altered bowel habits, significantly impairing patients’ quality of life. Emerging evidence suggests that gut dysbiosis plays a central role in IBS pathophysiology, with probiotics offering a potential therapeutic approach. However, inconsistent findings across studies highlight the need for a comprehensive meta-analysis to assess the effectiveness of broad-spectrum probiotics in IBS management. Objective: This meta-analysis aimed to evaluate the efficacy of broad-spectrum probiotics in reducing IBS symptoms and improving quality of life in adults. Methods: Following PRISMA guidelines, a systematic search was conducted across PubMed, Embase, Cochrane Library, and Web of Science to identify randomized controlled trials (RCTs) investigating broad-spectrum probiotics in IBS management. Studies assessing symptom severity, quality of life, and hospitalization rates with a minimum intervention duration of eight weeks were included. Data were extracted on study characteristics, intervention details, and clinical outcomes. Statistical analysis was performed using random-effects models to compute pooled effect sizes, odds ratios, and heterogeneity indices. Results: Eight RCTs comprising 2,575 participants met the inclusion criteria. Broad-spectrum probiotics significantly reduced IBS symptom severity compared to placebo (effect size range: -1.2 to -0.8, p < 0.01) and improved patient-reported quality of life (IBS-QOL score improvements). Subgroup analysis indicated that diarrhea-predominant IBS (IBS-D) patients, multi-strain probiotics, and longer treatment durations were associated with greater symptom relief. Heterogeneity ranged from 30% to 60%, and publication bias was identified but did not significantly alter the results after adjustment. Conclusion: This meta-analysis supports broad-spectrum probiotics as an effective IBS therapy, highlighting multi-strain, high-dose, long-duration benefits. Further large-scale RCTs needed.

Irritable Bowel Syndrome (IBS) is a disorder of gut- brain interaction characterized by recurrent abdominal pain associated with altered bowel habits. The therapeutic options for IBS patients include the use of probiotics. The aim of this study was to assess the effect of a multi-strain probiotic made up by Lactobacillus rhamnosus LR 32, Bifidobacterium lactis BL 04, and Bifidobacterium longum BB 536 (Serobioma, Bromatech s.r.l., Milano, Italy) on an in vitro model of the intestinal epithelial barrier in the presence of mucosal mediators that are released by IBS patients. IBS (n = 28; IBS with predominant diarrhea, IBS-D = 10; IBS with predominant constipation, IBS-C = 9; and IBS with mixed bowel habits, IBS-M = 9) patients, diagnosed according to the Rome IV criteria, and asymptomatic controls (ACs, n = 7) were enrolled. Mucosal mediators that were spontaneously released by colonic biopsies were collected (supernatants). Two doses of Serobioma were tested with/without IBS/AC mediators. RNA was extracted from Caco-2 cells to evaluate the tight junction (TJ) expression. Serobioma (106 CFU/mL) significantly reinforced the Caco-2 monolayer compared to growth medium alone (p < 0.05). IBS supernatants significantly increased Caco-2 paracellular permeability compared to the AC supernatants. The co-incubation of Caco-2 cells with IBS supernatants and Serobioma (106 CFU/mL) avoided the paracellular permeability alterations that were induced by IBS supernatants alone (p < 0.001), and, in particular, IBS-D and IBS-M ones. The co-incubation of Serobioma (106 CFU/mL) and IBS-D supernatants significantly increased ZO-1 expression compared to Caco-2 cells incubated with supernatants alone (p < 0.05), as confirmed via qPCR analyses. Serobioma (106 CFU/mL) counteracts the paracellular permeability changes that are induced by IBS supernatants, in particular IBS-D and IBS-M supernatants, likely modulating ZO-1 expression.

This article reports a rare case of extraosseous myxoid chondrosarcoma originating from the gallbladder. The patient, a 50-year-old female, presented with recurrent right upper quadrant abdominal pain for over two months, with worsening symptoms in the month prior to admission. Before hospitalization, enhanced computed tomography (CT) of the upper abdomen performed at a local hospital suggested a malignant gallbladder tumor (gallbladder cancer) with lymphadenopathy near the hepatic portal, as well as chronic cholecystitis with gallstones. Upon admission, whole-abdomen enhanced CT and liver-enhanced magnetic resonance imaging (MRI) confirmed uneven thickening of the gallbladder wall and multiple enlarged lymph nodes in the hepatic portal, further supporting the suspicion of gallbladder cancer. Tumor marker tests revealed elevated levels of carbohydrate antigen 19-9 (CA19-9) and cytokeratin 19 fragment. On 12 March 2020, the patient underwent extended radical resection for gallbladder cancer. The procedure included the removal of the gallbladder, hepatic lobe, right half of the colon, and greater omentum, along with extensive lymphadenectomy of the hepatic portal and posterior of the pancreatic head. Postoperative pathological examination confirmed the diagnosis of extraosseous myxoid chondrosarcoma, with the tumor involving the full thickness of the gallbladder, intrahepatic parenchyma, and the serosa to the muscular layer of the intestinal wall. Hematoxylin and eosin staining results supported this diagnosis. The patient recovered well postoperatively and did not receive any additional antitumor therapies, such as chemotherapy or radiotherapy. During a 36-month follow-up period after surgery, no tumor recurrence or metastasis was observed.

A 64‐year‐old woman had undergone subtotal stomach‐preserving pancreaticoduodenectomy for locally advanced pancreatic head cancer. She had an uneventful postoperative course with no recurrence. However, approximately 18 months after surgery, she presented with recurrent abdominal pain. Although contrast‐enhanced computed tomography abdominal radiographs showed internal stent migration to the residual pancreas, dilatation of the tail side of the pancreatic duct was observed. The impaired internal stent was considered to be the cause of the abdominal pain. An attempt to remove the stent via balloon‐assisted endoscopy was unsuccessful as the pancreaticojejunostomy site could not be reached. Consequently, endoscopic ultrasonography‐guided pancreatic duct drainage was performed, and a plastic stent was placed through the jejunal site to the stomach. Two months later, the endosonographically/endoscopic ultrasonography‐guided created route was dilated, and an endoscopic introducer was inserted into the pancreatic duct. Biopsy forceps were advanced through the sheath, allowing the successful removal of the stent by direct grasping. The symptoms of the patient improved, and she was discharged without complications.

To explore the clinical phenotype and genetic characteristics of a pediatric child with RELA-associated autoinflammatory disease (RAID) caused by a RELA gene variant, and to review the reported cases in the literature. A pediatric child with RAID who presented with recurrent fever, vomiting, and oral ulcers for over 5 years was selected as the study subject. The child visited the Women and Children's Hospital of Ningbo University in August 2023. Clinical data were collected, and peripheral blood samples were obtained from the child and his family members for whole-exome sequencing (WES) and Sanger sequencing to identify and validate candidate variants. The pathogenicity of the variants was analyzed accordingly. Using the keywords "RELA" "NF-κB" "autoinflammatory disease" "tofacitinib" "sulfasalazine" a literature search was conducted in the China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, and PubMed from January 1, 2000 to December 13, 2023. This study was approved by the Medical Ethics Committee of the Women and Children's Hospital of Ningbo University (Ethics No. EC2020-048). The child primarily manifested with recurrent fever, vomiting, and oral ulcers. WES identified a heterozygous nonsense variant c.985C>T (p.Arg329Ter) in the RELA gene, which was inherited from the mother. According to the American College of Medical Genetics and Genomics (ACMG) Standards and Guidelines for the Interpretation of Sequence Variants and the Clinical Genome Resource (ClinGen) recommendations for PVS1, this variant was classified as pathogenic (PVS1+PM2_Supporting+PP4). Despite treatment with adalimumab and tocilizumab, the child's symptoms persisted. Switching to tofacitinib improved oral ulcers, but fever and vomiting continued. The addition of thalidomide significantly alleviated fever and vomiting, and the patient's growth and development remained normal. A literature review identified 14 unrelated RAID families, including a total of 35 cases (including the present child). The main clinical features were recurrent oral ulcers, genital ulcers, skin problems, fever, diarrhea, abdominal pain, and vomiting. The nonsense variant c.985C>T (p.Arg329Ter) in the RELA gene is likely the genetic cause of the child's recurrent fever, vomiting, and oral ulcers. WES is valuable for timely diagnosis of RAID and provides a basis for clinical treatment strategies.

Cannabinoid hyperemesis syndrome (CHS) is recurrent nausea, vomiting, and abdominal pain due to prolonged cannabis use. This study aimed to differentiate the significant overlap in presentations of diabetic gastroparesis (DG) and CHS in people with type 1 diabetes. It found that older age, longer diabetes duration, female sex, lower A1C, and presence of diabetic neuropathy are indicators favoring a diagnosis of DG over CHS in people with type 1 diabetes.

Introduction: Recurrent Abdominal Pain (RAP) has a devastating impact on children’s activities and mental health. In this context, physicians often empirically start antibiotics with each visit. As a result, the normal commensal Escherichia coli (E. coli), which protects the gut through immunophysiological functions, decreases in number, becomes pathogenic and develops resistance to antibiotics. This imbalance between the host and the gut microbiome presents as abdominal discomfort. Aim: To investigate the response of normal gut flora E. coli to commonly used empirical antibiotics and its association with persistent cases of RAP in children. Materials and Methods: A cross-sectional study was conducted on 64 children under 10 years of age with RAP over a period from March 2021 to February 2022 at the Gayatri Vidya Parisad (GVP) Medical College and Hospital, Visakhapatnam, Andhra Pradesh, India. Stool culture and sensitivity, as well as the empirical use of antibiotics, were recorded. The bacteriological profile and their sensitivity were analysed. The major bacteria, E. coli, that were resistant to third-generation cephalosporins were further processed phenotypically using the disc diffusion method to detect their Extended Spectrum Beta-Lactamase (ESBL) production. Data were analysed using Statistical Package for Social Sciences (SPSS) software version 20.0. Results: Out of 64 children with RAP, 36 (56.3%) cases were persistent in nature, and 40 (62.5%) were under five years of age, with a predominance of girls 36 (56.3%). Among these 36 (56.3%) RAP cases, 16 (25%) were found mostly around the epigastrium with a periumbilical area. The major bacteria isolated were E coli 27 (87.1%) found in 31 (73.8%) positive stool culture from persistent RAP cases on empirical antibiotics with 22 (81.5%) being resistant to third-generation cephalosporins (Cefotaxime 17 (62.9%), Ceftazidime 12 (44.5%), Ceftriaxone 8 (29.6%)). Out of 22 (81.5%) third-generation cephalosporinresistant E. coli, 15 (68.2%) were ESBL producers. Conclusion: ESBL-producing E. coli were one of the common causes of persistent cases of RAP, attributed to the empirical overuse of third-generation cephalosporins by health professionals. There is a need for the rational use of antibiotics.

A 31-year-old woman presented with a 7-year history of recurrent upper abdominal pain and vomiting that exacerbated after meals, and a history of substantial weight loss. At presentation, her weight and BMI were 26 kg and 15.6 kg/m2, respectively. Routine blood tests and an abdominal ultrasonogram did not reveal any abnormality. However, endoscopy revealed mild duodenal bulb deformity, while barium studies and CT scans demonstrated narrowing of the third part of the duodenum. Consequently, after exclusion of other potential causes, the patient was diagnosed with Superior Mesenteric Artery Syndrome (SMAS), a rare condition where the duodenum becomes compressed between the aorta and superior mesenteric artery, often due to weight loss. Treatment began with naso-jejunal feeding, with plans for surgical intervention if no improvement was seen after 6 weeks. However, two weeks after starting treatment, she improved symptomatically, gained five kilograms of weight, and was able to take food without pain. So, the naso-jejunal tube was removed. This case highlights the importance of considering SMAS in patients with unexplained weight loss, abdominal pain, and vomiting, particularly in young women. Early diagnosis through careful clinical evaluation and radiological investigations is crucial for effective management.

This article presents a case report of a rare instance of hepatic cystic echinococcosis (Type II). The patient is a young female who has resided in the Inner Mongolia region of China for an extended period and has a clear history of contact with dogs and sheep. She presented with recurrent upper abdominal pain accompanied by jaundice of skin and sclera for 2 months. Through comprehensive clinical history inquiry, physical examination, and imaging studies such as ultrasound and computed tomography, the diagnosis of hepatic cystic echinococcosis (Type II) was confirmed. The patient underwent a capsular excision, and the postoperative prognosis was good with no recurrence or implantation during short-term follow-up. This case report details the patient's clinical symptoms, signs, diagnostic process, and key points for differential diagnosis, emphasizing the crucial role of imaging studies in the diagnosis of hepatic cystic echinococcosis. Additionally, the treatment plan and postoperative follow-up for this case are discussed, aiming to provide a reference for clinical diagnosis and treatment of hepatic cystic echinococcosis.

Concretion or mass formed of exogenous undigested material in the gastrointestinal tract is called bezoar. Bezoar is a rare condition and can present with clinical features ranging from recurrent abdominal pain to acute presentation with obstruction or gastrointestinal bleeding. Preoperative diagnosis is usually done by imaging studies. They are treated with endoscopic or surgical removal of the bezoar along with treatment of complications and underlying illness. Here, we present two cases of bezoars: first, a case of a duodenal lithobezoar in 35-year-old male who presented with features of gastric outlet obstruction. He was found to have duodenal stricture and multiple small lithobezoars in the stomach and duodenum. The bezoars were removed by laparotomy and gastrotomy; and gastrojejunostomy was done to bypass the stricture. The second was a jejunal phytobezoar in 42-year-old male who presented with jejunal obstruction. Laparotomy and resection of the involved segment of jejunum and end-to-end anastomosis were done. Both the patients improved without postoperative complications.

A Rare Cause of Recurrent Abdominal Pain.

Small bowel neuroendocrine tumors (NETs) are rare but are increasing in incidence advances in imaging techniques. NETs are a heterogeneous group of tumors with diverse clinical and imaging presentations. Although these tumors are typically smaller in size, they can cause significant fibrotic reactions in the bowel wall, lymph nodes, and mesentery. Due to the relatively rare occurrence of these tumors, limited awareness among physicians and nonspecific clinical symptoms, patients with small bowel NETs often experience considerable delays in diagnosis and inappropriate management. We present a case of a 58-year-old female who came with recurrent abdominal pain, distension, vomiting, significant weight loss and poor appetite. Although imaging findings were suggestive of a mesenchymal tumor, intraoperatively we could find a stricturising lesion in the ileum with a mesenteric mass. She underwent resection and anastomosis of the small bowel lesion along with mesenteric nodal excision. Interestingly, the postoperative biopsy revealed a well-differentiated Grade 2 intermediate-grade ileal NET with mesenteric nodal involvement. On immunohistochemistry (IHC), tumour cells show low Ki-67 index with positive for chromogranin and synaptophysin.

Chronic pancreatitis (CP) in children has exhibited an annual increase in incidence in recent years. Pediatric CP presents unique clinical features compared to adult cases. Endoscopic retrograde pancreatography (ERP) serves as a valuable and safe tool for diagnosing and treating CP in adults. However, data on endoscopic treatment of CP in children are still limited. Demographics, etiology, surgical indications, diagnosis, treatment details, associated complications, and follow-up information were retrospectively studied in consecutive patients (<18 years old) who underwent ERP for CP between January 2020 and October 2024. A total of 17 children (7 male, 10 female) with a mean age of 10.0 ± 2.7 years were included in the study. A total of 34 endoscopic treatments were conducted. Recurrent abdominal pain was the primary clinical symptom. Imaging predominantly revealed pancreatic duct abnormalities such as tortuous dilatation and the presence of pancreatic duct stones. Notably, 41.2% (7 cases) involved genetic and congenital anatomical variations. Pancreatic duct stent placement was successfully performed in all 17 children (100.0% success rate). Stent replacements occurred on average 2.2 times (range 1-5) at intervals of 3-6 months. Postoperative pancreatitis developed in 2 cases (5.9%, 2/34), and hyperamylasemia occurred in 5 cases (14.7%, 5/34). The postprocedure visual analogue scale (VAS) score for abdominal pain significantly decreased from 6 to 1 (P < 0.001). The annual frequency of pancreatitis episodes showed a significant reduction, decreasing from 2.4 times pre-treatment to 0.6 times post-treatment (P < 0.05). Body mass index (BMI) also showed a significant improvement post-treatment compared to pre-treatment (P < 0.05). ERP performed by trained endoscopists utilizing standard adult endoscopes and accessories proved a safe and effective treatment option for pediatric CP, with complication rates comparable to those reported in adult cases.

Introduction: Acute intermittent porphyria is a disease inherited in an autosomal dominant manner, occurring with a frequency of 1:75,000 people. The main symptom of the disease is paroxysmal, colicky abdominal pain, which is accompanied by neuropsychiatric symptoms. For some patients, psychiatric symptoms are the only symptom of the disease. In this paper, the case of a 43-year-old patient struggling with recurrent colicky abdominal pain and depressive and anxiety disorders, which intensify during exacerbation periods, is presented, featuring an ambiguous diagnosis of porphyria in previous laboratory tests. In the treatment, glucose infusions, morphine, psychiatric and psychological therapy were used - saline solution was administered as a placebo. Aim: The aim of this paper is to highlight the difficulties in diagnosing psychiatric symptoms during an acute attack of porphyria, which significantly complicate its treatment, and to consider the possibility of using placebo as one of the elements in the diagnostic and therapeutic plan in order to optimize treatment and avoid complications by using smaller doses of narcotic drugs. Review methods: A thorough analysis of research studies available on PUBMED was conducted using the following keywords: acute intermittent porphyria; porphobilinogen; depression; anxiety disorders; psychiatry; placebo. The medical history of a 43-year-old female patient, suspected of having acute intermittent porphyria due to recurrent abdominal pain and psychiatric symptoms, was also analyzed. Conclusion: Our case illustrates how psychiatric symptoms can complicate the diagnosis of acute intermittent porphyria. Failing to recognize acute porphyria also carries the risk of life-threatening complications and may lead to unnecessary pharmacotherapy and stigmatization as a mental illness. This case demonstrates that placebo can be one of the components of a diagnostic and therapeutic plan of acute intermittent porphyria.

Irritable bowel syndrome (IBS) is a common disorder characterized by recurrent abdominal pain and altered bowel habits, often accompanied by bloating.1-4 IBS is classified by its predominant bowel symptom: constipation (IBS-C), diarrhea (IBS-D), mixed type (IBS-M), or unclassified (IBS-U).1 Since the exact cause of IBS is unknown, the goal of treatment is symptom control.

Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, primarily arises from defects in the colonic barrier, imbalances of the gut microbiota, and immune response issues. These complex causes make it difficult to achieve a complete cure. Patients with IBD frequently experience recurrent abdominal pain and bloody diarrhea, while severe cases may result in intestinal obstruction, perforation, and cancer. Lifelong maintenance therapy may thus be needed to manage these symptoms; however, traditional IBD drugs, such as 5-aminosalicylic acid, glucocorticoids, immunosuppressants, and biological agents, are often associated with problems including poor solubility, instability, and ineffective targeting, as well as causing serious side effects in non-target tissues. Nanomaterial drug delivery systems (NDDS) have recently shown great promise in optimizing drug distribution, solubility through biocompatible coatings, enhancing bioavailability via PEGylation and reducing side effects. These formulations can enhance a drug's pharmacokinetics by modifying its properties, improve its ability to cross barriers, and boost bioavailability. In addition, NDDS can enable targeted delivery, increase local drug concentrations, improve efficacy, and reduce side effects, as well as protecting active drug molecules from immune recognition and protease degradation. The clinical use of these systems for treating IBD, however, requires further research. This review summarizes the classification of NDDS for IBD, and concludes that, despite ongoing challenges, NDDS may represent an effective treatment approach for IBD. In summary, NDDS enhance the targeted delivery of therapeutic agents to specific cells or tissues, thereby improving drug bioavailability and therapeutic efficacy. These systems effectively surmount biological barriers, facilitating efficient drug delivery to targeted sites, which is crucial for attaining optimal therapeutic outcomes. This review contributes to a deeper understanding of how the physicochemical properties of NDDS influence pharmacological behavior in vivo and can expedite their clinical translation.

Background: Chronic pancreatitis is a progressive inflammatory condition of the pancreas, leading to irreversible structural damage, pain, and functional impairment, including malabsorption and diabetes mellitus. Its clinical presentation varies, often including recurrent abdominal pain, weight loss, and steatorrhea. This study aimed to evaluate clinical presentation and treatment outcomes of chronic pancreatitis. Methods: This retrospective study was conducted at the Department of Hepatobiliary, Pancreatic &amp; Liver Transplantation Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2005 to June 2008. A total of 30 diagnosed patients with chronic pancreatitis were enrolled purposively. Data were analyzed by using MS Office tools. Results: Most patients in this study present with recurrent upper abdominal pain, often accompanied by nausea and vomiting in 60% of cases. The pain is typically dull, relieved by antispasmodics, and improves on an empty stomach or when leaning forward. Treatment outcomes reveal that 80% of patients undergo surgery, with 7 experiencing complications such as external pancreatic fistula, wound infections, and pancreatic exocrine insufficiency. Some patients experience pain recurrence, requiring revision surgery. A small percentage receive medical treatment or undergo ERCP for pain and related complications. Conclusion: Chronic pancreatitis patients often have recurrent upper abdominal pain, nausea, and vomiting. The pain is dull, relieved by antispasmodics, and improves when the stomach is empty or leaning forward. Surgery outcomes are generally positive, though complications like pancreatic fistula, infections, and exocrine insufficiency may occur. Some require revision surgery.