Original article—liver, pancreas, and biliary tractDietary Counseling Versus Dietary Supplements for Malnutrition in Chronic Pancreatitis: A Randomized Controlled Trial
Section snippets
Methods
We conducted an RCT in our tertiary care academic center. Consecutive patients with CP attending the pancreas clinic at our center were included in the study during the period starting August 2000–July 2003. The diagnosis of CP was suspected on the basis of suggestive clinical features, ie, recurrent or chronic abdominal pain and/or presence of diabetes and/or steatorrhea. The diagnosis was confirmed if there was evidence of pancreatic calcification and/or ductal changes in the form of
Baseline Clinical Profile
The clinical characteristics of patients randomized to dietary counseling and to dietary supplementation have been described in Table 1. The mean age of the patients was 30 years (±10); 83% were men. The etiology of CP was alcoholic in 40% and idiopathic in 59%. The baseline hematology and biochemical parameters of patients in both the groups are given in Table 2.
Of the 60 patients studied, 29 were randomized to receive dietary counseling alone, whereas 31 received dietary supplements. There
Discussion
Patients with CP might experience maldigestion and malnutrition.4 Chronic inflammation and fibrosis in the gland can destroy exocrine tissue, leading to inadequate delivery of digestive enzymes to the duodenum in the prandial and postprandial periods and subsequent maldigestion. Maldigestion is augmented by inadequate bicarbonate delivery to the duodenum, with secondary inactivation of enzymes and bile acids by gastric acid.23 Abdominal pain, sitophobia, nausea, vomiting, postprandial satiety,
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The study was supported by a research grant from the Indian Council of Medical Research, New Delhi.