4.3 Article

Effects of Oral Ingestion of the Elemental Diet in Patients With Painful Chronic Pancreatitis in the Real-Life Setting in Japan

Journal

PANCREAS
Volume 43, Issue 3, Pages 451-457

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MPA.0000000000000038

Keywords

chronic pancreatitis; low-fat elemental diet; visual analog scale; body mass index; pain resolution; Alb - albumin; BMI - body mass index; CRP - C-reactive protein; GP - general practitioner clinics; Hb(A1c) - hemoglobin A1c; HP - hospitals; MCT - medium-chain triglycerides; QOL - quality of life; SD - standard deviation; UHP - university hospitals; VAS - visual analog scale

Funding

  1. Ajinomoto Pharmaceuticals Co, LTD, Tokyo, Japan

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Objective Most patients with chronic pancreatitis develop intractable abdominal pain and malnutrition. A low-fat diet is one of the options used to manage intractable abdominal pain and malnutrition. However, few reports have examined the pain-suppression effect. To investigate the effects of oral ingestion of a low-fat elemental diet composed of purified amino acids on pain and nutritional status in patients with chronic pancreatitis, a multicenter prospective study was conducted. Methods Patients with chronic pancreatitis with symptoms of abdominal pain were enrolled. In addition to meals, patients ingested a low-fat elemental diet composed of purified amino acids for 12 weeks. Before and after treatment, patients were asked to indicate their pain grade using a 100-mm horizontal visual analog scale, and nutritional indices, including body mass index and blood levels of pancreatic enzymes, were measured. Results A total of 596 patients were eligible for analysis. Marked pain reduction was observed with a significant decrease of the mean visual analog scale score by 32.9 mm from 52.9 mm after 12 weeks (P < 0.001). There were also significant improvements in nutritional indices. Conclusions An oral low-fat elemental diet composed of purified amino acids, which requires no special treatment procedures, may improve patients' quality of life.

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