Medical Management of Chronic Pancreatitis in Children: A Position Paper by the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Pancreas Committee

• Type of Material: Article
• Authors: A Jay. Freeman, Emory University; Asim Maqbool, University of Pennsylvania; Melena D. Bellin, University of Minnesota; Kenneth R. Goldschneider, Cincinnati Childrens Hospital Medical Center; Amit S. Grover, Harvard Medical School; Travis L. Piester, University of Southern California; Cheryl Hartzell, Emory University; Flora Szabo, Virginia Commonwealth University; Bridget Dowd Kiernan, University of Pennsylvania; Racha Khalaf, University of Colorado; Rakesh Kumar, Promed Toledo Childrens Hospital; Mirta Rios, Nicklaus Childrens Hospital; Sohail Z. Husain, Stanford University; Veronique D. Morinville, McGill University; Maisam Abu-El-Haija, Cincinnati Childrens Hospital Medical Center
• Language: English
• Date: 2021-02-01
• Publisher: Lippincott Wilkins & Williams
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © ESPGHAN and NASPGHAN. All rights reserved.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1097/MPG.0000000000003001
• Title of Journal or Parent Work: Journal of Pediatric Gastroenterology and Nutrition
• Volume: 72
• Issue: 2
• Start Page: 324
• End Page: 340
• Grant/Funding Information: This position paper was supported through NASPGHAN. No additional funding was received.
• Keywords: Science & Technology; Antioxidants; Pediatrics; pain management; Alcohol consumption; Endoscopic ultrasound; Intestinal bacterial growth; position paper; nutrition; chronic pancreatitis; Life Sciences & Biomedicine; Diabetes-mellitus; Gastroenterology & Hepatology; Quality of life (QoL); sequelae of chronic pancreatitis; Functional abdominal pain; Risk factors; Nutrition & Dietetics
• Research Categories: Health Sciences, Human Development; Health Sciences, Public Health; Health Sciences, Nutrition

Abstract

This position paper summarizes the current understanding of the medical management of chronic pancreatitis (CP) in children in light of the existing medical literature, incorporating recent advances in understanding of nutrition, pain, lifestyle considerations, and sequelae of CP. This article complements and is intended to integrate with parallel position papers on endoscopic and surgical aspects of CP in children. Concepts and controversies related to pancreatic enzyme replacement therapy (PERT), the use of antioxidants and other CP medical therapies are also reviewed. Highlights include inclusion of tools for medical decision-making for PERT, CP-related diabetes, and multimodal pain management (including an analgesia ladder). Gaps in our understanding of CP in children and avenues for further investigations are also reviewed.