Materiały źródłowe

• #1 Global epidemiology and holistic prevention of pancreatitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6597260/

  Holistic prevention of pancreatitis refers to a comprehensive approach to its prevention. Prevention approaches are classically categorized as primary, secondary and tertiary in terms of the intervention time point and target population. In primary prevention, intervention is applied to the general population who do not have a disease of interest. These strategies typically aim to reduce disease incidence. Secondary prevention involves early identification of individuals with an existing disease of interest. The purpose of secondary prevention is to apply effective intervention early and reduce morbidity. Tertiary prevention is applied after a disease of interest is established, aiming at minimizing its sequelae and resulting burden. […] The concept of multi-level prevention has been known since the 1980s and has proven to be useful in reducing the burden of several diseases. However, the opportunity to apply this concept holistically to diseases of the pancreas has been overlooked as most early research in pancreatology was focused on a single aspect of prevention reducing the number of recurrences of pancreatitis. By aetiology, the preventive interventions included cholecystectomy for biliary pancreatitis, alcohol counselling for alcohol-induced pancreatitis and tight control of lipidaemia for hypertriglyceridaemia-induced pancreatitis. Here, we propose the holistic prevention of pancreatitis (HPP) framework, which is based on the above core principles of prevention applied, for the first time, broadly and holistically to pancreatitis.

• #1 Global epidemiology and holistic prevention of pancreatitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6597260/

  Opportunities for multi-level prevention are available for all elements of the HPP framework. Implementation of HPP requires the concerted contributions of health care professionals from various disciplines, including primary care physicians, gastroenterologists, surgeons, radiologists, pain specialists, endocrinologists, dietitians and public health specialists. […] A comprehensive systematic review of general population-based studies evaluated more than 30 factors associated with diseases of the exocrine pancreas. This study estimated that more than half of pancreatitis cases could have been prevented if all people in the general population were non-smokers, nearly one-fourth of cases if all individuals in the general population were a normal weight, and nearly one-fifth of cases if they had limited alcohol consumption. The review also emphasized that consumption of vegetables and fruits is associated with a nearly 30% reduced risk of all diseases of the exocrine pancreas.

• #1

  https://www.nhs.uk/conditions/acute-pancreatitis/prevention/

  Acute pancreatitis is often caused by gallstones or drinking too much alcohol. A healthy lifestyle can reduce your chances of developing the condition. […] The most effective way of preventing gallstones is by eating a balanced diet that includes at least 5 portions of fresh fruit and vegetables a day. […] You can reduce your risk of developing acute pancreatitis by cutting back on drinking alcohol. This helps to prevent your pancreas being damaged. […] Remember, if you’ve had acute pancreatitis caused by drinking too much alcohol, you should avoid it completely.

• #1 5 Ways to Prevent Pancreatitis and Exocrine Pancreatic Insufficiency

  https://www.everydayhealth.com/hs/exocrine-pancreatic-insufficiency/prevent-pancreatitis-and-epi/

  When you go into crash-diet mode, prompting quick weight loss, your liver ramps up cholesterol production in response, which increases your risk for gallstones. […] A review of studies published in December 2019 in the journal Pancreatology found that adults who smoked were 1.5 times more likely to develop pancreatitis than nonsmokers. […] Pancreatitis can be a serious condition and, if left unmanaged, may progress to EPI. If you have risk factors for pancreatitis, make the appropriate lifestyle changes to prevent it.

• #1 5 Ways to Prevent Pancreatitis and Exocrine Pancreatic Insufficiency

  https://www.everydayhealth.com/hs/exocrine-pancreatic-insufficiency/prevent-pancreatitis-and-epi/

  Take these steps to prevent damage to your pancreas and reduce your risk for exocrine pancreatic insufficiency. […] Fortunately, there are steps you can take to reduce your risk for pancreatitis and related health problems. […] There are ways you can protect your pancreas and reduce your risk for pancreatitis and other serious health problems, such as EPI. […] By drinking less (or not at all), you can help protect your pancreas from the toxic effects of alcohol and reduce your risk for pancreatitis. […] To reduce your risk for gallstones, eat a heart-healthy diet that includes whole grains and a variety of fresh fruits and vegetables. […] Losing extra pounds and maintaining a healthy weight by eating a balanced diet and engaging in regular physical activity can help prevent gallstones from forming.

• #1

  https://link.springer.com/article/10.1007/s10620-025-08870-x

  Post-ERCP pancreatitis (PEP) is a morbid complication of ERCP that occurs in up to 15% of high-risk patients. Prevention of PEP involves multiple factors; as a highly operator-dependent technique, prioritizing optimal procedural training is essential in addition to careful patient selection, judicious risk stratification, and the choice of the most effective technical and pharmacological strategies to achieve optimal patient outcomes. […] Though for most patients, prophylactic rectal non-steroidal anti-inflammatory drugs (NSAIDs) and aggressive hydration remain the cornerstone of PEP prophylaxis, for high-risk cases (e.g., difficult cannulation or prior PEP), additional strategies such as pancreatic stent placement or modifications in techniques (e.g., early use of needle-knife fistulotomy or other advanced cannulation methods) may be warranted.

• #1 Prevention of ERCP-induced Pancreatitis | Pancreapedia

  https://pancreapedia.org/reviews/prevention-of-ercp-induced-pancreatitis

  Pancreatitis is a common, costly, and occasionally devastating complication of endoscopic retrograde cholangiopancreatography (ERCP). Since post-ERCP pancreatitis (PEP) is important and potentially preventable, a comprehensive approach to risk reduction should be employed by all who perform ERCP. Strategies to reduce the incidence of PEP, which should be considered in every case, include thoughtful patient selection, risk-stratification, sound procedural technique, prophylactic pancreatic stent placement, and pharmacoprevention. […] Given the magnitude of this problem, prevention of PEP remains a major clinical and research priority. […] Since PEP is potentially preventable, a comprehensive approach to risk reduction should be employed by all who perform ERCP. Preventive strategies can be broadly divided into 5 areas: (1) appropriate patient selection, (2) risk stratification of patients undergoing ERCP and meaningful use of this information in clinical decision-making, (3) atraumatic and efficient procedural technique, (4) prophylactic pancreatic stent placement, and (5) pharmacoprevention.

• #1 Prevention of ERCP-induced Pancreatitis | Pancreapedia

  https://pancreapedia.org/reviews/prevention-of-ercp-induced-pancreatitis

  Thoughtful patient selection prior to ERCP remains the most important strategy in reducing the incidence of PEP. […] A substantial amount of research over the last two decades has contributed to our understanding of the independent risk factors for post-ERCP pancreatitis. […] Armed with risk assessment information, clinicians can better inform patients about adverse events and tailor costly and potentially dangerous risk-reducing strategies. […] Efficient and atraumatic technical practices during ERCP are central to minimizing the risk of pancreatitis. […] One of many proposed mechanisms of PEP implicates impaired pancreatic ductal drainage caused by trauma-induced edema of the papilla. Pancreatic stent placement (PSP) is therefore thought to reduce the risk of PEP by relieving pancreatic ductal hypertension that develops as a result of transient procedure-induced stenosis of the pancreatic orifice.

• #1 Prevention of ERCP-induced Pancreatitis | Pancreapedia

  https://pancreapedia.org/reviews/prevention-of-ercp-induced-pancreatitis

  Despite these considerations, PSP is widely regarded as an effective means of preventing PEP, is commonly used in academic medical centers in the United States, and is recommended by the European Society of Gastrointestinal Endoscopy. […] Pharmacoprevention for PEP has been a major research priority in the last 3 decades. […] In the last decade, research focusing on rectal NSAIDs has provided renewed hope for pharmacoprevention. […] Despite this meta-analysis, however, NSAIDs were seldom used in clinical practice due to the absence of conclusive RCT evidence. […] Available data indicate that rectal NSAIDs are effective in addition to PSP in high-risk cases, but to date, there are no clinical trial data examining whether indomethacin is effective when administered instead of PSP. […] Despite the approaches outlined above, up to 15% of high-risk patients will still develop PEP. Appropriate patient selection, sound procedural technique, NSAIDs, and pancreatic stents have been effective in improving the problem, however additional research in multiple areas is necessary to achieve the goal of eliminating PEP.

• #1

  https://link.springer.com/article/10.1007/s10620-024-08565-9

  Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) remains the most frequent and severe complication following ERCP, elevating both patient suffering and healthcare costs, and posing challenges to the advancement of ERCP techniques. […] Empirical evidence supports the prophylactic use of nonsteroidal anti-inflammatory drugs (NSAIDs) in the prevention of PEP, especially in high-risk populations, as endorsed by both the American Society for Gastrointestinal Endoscopy (ASGE) and the European Society for Gastrointestinal Endoscopy (ESGE). […] The ASGE and the European Society for Gastrointestinal Endoscopy (ESGE) both highly recommend preoperative rectal NSAIDs for high-risk patients. […] In recent years, NSAID utilization has expanded to include unselected PEP patients due to their cost-effectiveness.

• #1 How and When Should NSAIDs Be Used for Preventing Post-ERCP Pancreatitis? A Systematic Review and Meta-Analysis | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0092922

  Non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to be efficacious to prevent pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). […] The objective of the study was to evaluate these questions by performing a systematic review and meta-analysis. […] The risk of pancreatitis was lower in the NSAID group than in the placebo group (RR 0.51; 95%CI 0.390.66). […] A single rectal dose of indomethacin or diclofenac before or immediately after ERCP is safe and prevents procedure-related pancreatitis both in high risk and in unselected patients. […] Previous meta-analyses have suggested that NSAIDs are effective in preventing post-ERCP pancreatitis, and the ESGE guidelines recommend routine rectal administration of 100 mg of diclofenac or indomethacin immediately before or after ERCP.

• #1

  https://link.springer.com/article/10.1007/s10620-024-08565-9

  Despite ongoing debates, the latest recommendations from ASGE 2023 and ESGE 2019 strongly advocate for NSAID use in patients without contraindications. […] The 2023 ASGE guidelines recommend the perioperative use of NSAIDs as a preventive measure for PEP during ERCP. […] Current guidelines do not specify preferred NSAIDs. […] Thus, the current standard dose of 100 mg indomethacin or diclofenac remains safe and effective for PEP prevention, with no notable benefits from dosage adjustments observed. […] Collectively, NSAID monotherapy remains a potent, cost-effective prophylactic option against PEP, especially in patients without heightened risk factors. […] Preventing PEP with NSAIDs is cost-beneficial for all patients, especially in countries with low-cost NSAIDs.

• #1 A Review of Prevention of Post-ERCP Pancreatitis – Gastroenterology & Hepatology

  https://www.gastroenterologyandhepatology.net/archives/may-2018/a-review-of-prevention-of-post-ercp-pancreatitis/

  Despite substantial evidence supporting prophylactic pancreatic duct stent placement, there are several limitations to consider. […] Rectal Nonsteroidal Anti-Inflammatory Drugs as Pharmacoprevention […] Ultimately, these authors suggest the use of rectal indomethacin unequivocally for all high-risk patients. For the average-risk patient, based on the current data, we defer rectal NSAID use to operator preference. […] Aggressive intravenous fluid administration has been the mainstay of pancreatitis treatment for many years. […] Because intravenous hydration is important in treating pancreatitis, aggressive administration of intravenous fluids during ERCPs may help to prevent or limit the severity of PEP.

• #1

  https://link.springer.com/article/10.1007/s10620-025-08870-x

  Combined use of rectal NSAIDs and aggressive volume replacement therapy with lactated Ringer solution was significantly more effective than either single treatment according to a recent network meta-analysis. […] While current international guidelines (ASGE, ESGE, JPN) recommend rectal NSAIDs and pancreatic stenting, real-world practice and data from the study of Weiland et al. reveal a subgroup of patients who still remain at significant risk. […] This IPDMA confirms the effectiveness of established prophylactic measures for PEP, although it highlights the need for personalized strategies in high-risk patients. Future research should focus on combination therapies and advanced risk stratification tools to further reduce PEP incidence, optimize resource allocation, and improve the safety and efficacy of ERCP, ultimately enhancing patient outcomes.

• #1 Nafamostat for Prophylaxis against Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis Compared with Gabexate

  https://www.gutnliver.org/journal/view.html?volume=3&number=3&spage=205

  Nafamostat for Prophylaxis against Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis Compared with Gabexate […] The protease inhibitors, nafamostat and gabexate, have been used to prevent pancreatitis related to endoscopic retrograde cholangiopancreatography (ERCP). In vitro, nafamostat inhibits the pancreatic protease activities 10-100 times more potently than gabexate. We evaluated the efficacy of nafamostat for prophylaxis against post-ERCP pancreatitis in comparison with gabexate. […] Five hundred patients (208 patients in the nafamostat-treated group and 292 in the gabexate-treated group) were analyzed retrospectively after selective exclusion. The incidences of pancreatitis and hyperamylasemia after the ERCP were compared between the nafamostat and gabexate groups.

• #1 Global epidemiology and holistic prevention of pancreatitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6597260/

  The form of acute pancreatitis particularly amenable to primary prevention by gastroenterologists is pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). Avoidance of futile ERCP and the appropriate choice of sedation for ERCP, rectal administration of nonsteroidal anti-inflammatory drugs, and optimization of cannulation technique in patients at high-risk have proven to be beneficial. Pharmacological interventions (statins in particular) are being trialled as a means of primary prevention of recurrent acute pancreatitis and results are eagerly awaited. […] The emerging aspect of secondary prevention of acute pancreatitis is epitomized in the concept of gut rousing, which has replaced the pancreas rest concept that dominated the field in the 20th century. The new concept has been developed to prevent progression of acute pancreatitis severity by optimizing the use of the three mainstays of early management opiates, fluids and nutrition.

• #1 Antibiotic Prophylaxis for Severe Acute Pancreatitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0101/p49.html

  No, antibiotic prophylaxis does not decrease mortality in patients with severe acute pancreatitis, defined as pancreatitis associated with pancreatic necrosis. (Strength of Recommendation: A, based on meta-analyses of randomized controlled trials [RCTs] and a single RCT.) […] Overall, antibiotic prophylaxis did not decrease mortality compared with placebo (relative risk [RR] = 0.60; 95% confidence interval [CI], 0.34 to 1.1). […] This meta-analysis also showed no mortality benefit from antibiotic prophylaxis (N = 439; RR = 0.76; 95% CI, 0.49 to 1.2). […] Antibiotic prophylaxis is not protective in severe acute pancreatitis: a systematic review and meta-analysis.

• #1 Antibiotic Prophylaxis in Severe Acute Pancreatitis: Do We Need M

  https://www.primescholars.com/articles/antibiotic-prophylaxis-in-severe-acute-pancreatitis-do-we-need-more-metaanalytic-studies-98167.html

  Overall, there was no protective effect of antibiotic treatment with respect to mortality. With respect to morbidity, antibiotic prophylaxis did not protect against infected necrosis or surgical intervention. […] There was, however, an apparent benefit as regards nonpancreatic infections, with a relative risk reduction of 40%, absolute risk reduction of 15%, and number needed to treat of 7. […] In fact, results from a recent randomized trial, showing a significant reduction in extrapancreatic sepsis by starting antibiotic prophylaxis on admission to hospital, support this hypothesis. […] In conclusion, we do not need more meta-analytic studies on this topic; on the contrary, additional and well-carried out studies are required to explore the benefits of antibiotic prophylaxis in severe acute pancreatitis, also taking into account the adverse effects, the effects of the varying duration of the therapy, and whether the outcome of the infection is related to the etiology.

• #1 Antibiotic Prophylaxis in Severe Acute Pancreatitis: Do We Need M

  https://www.primescholars.com/articles/antibiotic-prophylaxis-in-severe-acute-pancreatitis-do-we-need-more-metaanalytic-studies-98167.html

  Several guidelines on acute pancreatitis suggest that carbapenems should be used prophylactically and should be continued for 14 days, and that the development of infected necrosis should be assessed using fine-needle aspiration and the sample should be cultured for germ isolation and characterization. […] In routine clinical practice, antibiotics are used to cure both extrapancreatic infections which appear during the course of acute pancreatitis and infected pancreatic necrosis and also as a prophylaxis in those patients who have pancreatic necrosis in order to prevent possible infection from the necrosis. […] There are very few human randomized studies and there are more meta-analyses published than studies published. […] Thus, I would like to discuss the latest meta-analytic study coming from the United States.

• #1 Is antibiotic prophylaxis beneficial in acute pancreatitis? – First update – Medwave

  https://www.medwave.cl/puestadia/resepis/6125.html?lang=en

  The certainty of the evidence is low, so it is difficult to estimate the balance between benefits and risks, which will probably change with new information. […] The direct cost of prophylactic antibiotics and the indirect cost derived from their excessive use are high, especially in critical care units. […] The probability of new evidence changing what we know is high. Any recommendation formulated at this moment should be reviewed in the light of new evidence.

• #1 Probiotic prophylaxis in patients with predicted severe acute pancreatitis (PROPATRIA): design and rationale of a double-blind, placebo-controlled randomised multicenter trial [ISRCTN38327949] | springermedizin.de

  https://www.springermedizin.de/probiotic-prophylaxis-in-patients-with-predicted-severe-acute-pa/9512772

  Infectious complications are the major cause of death in acute pancreatitis. Goal of this study is to determine whether selected probiotics are capable of preventing infectious complications without the disadvantages of antibiotic prophylaxis; antibiotic resistance and fungal overgrowth. […] The study objective is to show that probiotics are effective in reducing the number of infectious complications during the course of acute pancreatitis. […] The PROPATRIA study is aimed to show a reduction in infectious complications due to early enteral use of multispecies probiotics in severe acute pancreatitis. […] It is the goal of the present study to investigate the use of prophylactic probiotics as an alternative strategy. […] Probiotics are living micro-organisms that upon oral delivery exert a range of health promoting properties.

• #1 Probiotic prophylaxis in patients with predicted severe acute pancreatitis (PROPATRIA): design and rationale of a double-blind, placebo-controlled randomised multicenter trial [ISRCTN38327949] | BMC Surgery | Full Text

  https://bmcsurg.biomedcentral.com/articles/10.1186/1471-2482-4-12

  Infectious complications are the major cause of death in acute pancreatitis. Goal of this study is to determine whether selected probiotics are capable of preventing infectious complications without the disadvantages of antibiotic prophylaxis; antibiotic resistance and fungal overgrowth. […] The PROPATRIA study is aimed to show a reduction in infectious complications due to early enteral use of multispecies probiotics in severe acute pancreatitis. […] The study objective is to show that probiotics are effective in reducing the number of infectious complications during the course of acute pancreatitis. […] The primary endpoint is the total numbers of infectious complications during the hospital stay for acute pancreatitis. […] PROPATRIA is a double-blind, placebo-controlled randomised multicenter trial that aims to show a reduction in infectious complications by the enteral use of a multispecies probiotics preparation in patients with predicted severe acute pancreatitis.

• #1 Prophylaxis and treatment with antibiotics or probiotics in acute pancreatitis | Pancreapedia

  https://pancreapedia.org/reviews/prophylaxis-and-treatment-with-antibiotics-or-probiotics-in-acute-pancreatitis

  Early in the disease course of necrotizing pancreatitis two treatment strategies have been suggested to prevent secondary infection of peripancreatic collections and pancreas necrosis: […] Prophylactic administration of antibiotics […] Probiotic prophylaxis is not recommended for the prevention of infectious complications in acute pancreatitis. (GRADE 1B, strong agreement) […] Intravenous antibiotic prophylaxis is not recommended for the prevention of infectious complications in acute pancreatitis. (GRADE 1B, strong agreement)

• #1 Factors predisposing to severe acute pancreatitis: evaluation and prevention

  https://www.wjgnet.com/1007-9327/full/v9/i5/1102.htm

  AIM: To analyze factors predisposing to the infections associated with severe acute pancreatitis (SAP) and to work out ways for its prevention. […] Comprehensive prevention of pancreatic infection and practice of individualized therapy contribute to reducing the incidence of infection. […] To prevent secondary pancreatic infection is essential to reducing the mortality of SAP. Therefore it is of chief importance to understand the factors related to pancreatic infection before any prevention is undertaken against it. […] Comprehensive preventions include: (1) blood volume supplementation, shock correction and especially preventions against multi-organ low perfusion injury and MOSF in the earlier stage of SAP. […] (3) intestinal decontamination to facilitate the recovery of gastrointestinal function: traditional Chinese cathartic herbs including castor oil and magnesium sulfate were early administrated to achieve decontamination, which not only decrease the population of intestinal bacteria but also promote gastrointestinal peristalsis eliminating „dead cavities”.

• #1 Factors predisposing to severe acute pancreatitis: evaluation and prevention

  https://www.wjgnet.com/1007-9327/full/v9/i5/1102.htm

  (4) preventive administration of antibiotics: the antibiotics against G- bacilli especially those capable of passing through the blood-pancreas barrier such as third generation cephalosporin, imipenem, tinidazole, etc are effective, while other antibiotics such as first generation cephalosporin, ampicillin, amikacin, etc have been proved ineffective thus improper for prescription. […] (5) nutritional support: enough energy should be supplemented by means of EN (enteral nutrition) or TPN (total parenteral nutrition) to stop self burning, potentiate resistance against infection and accelerate tissue healing. […] (6) peritoneal lavage and drainage of effusion: When large amount of ascites develops in SAP patients, active peritoneal lavage or ultrasonic B or CT guided drainage through a small abdominal incision should be employed to eliminate activated inflammatory mediators and toxic peritoneal exudates, so that toxin intake and intra-peritoneal hyperbaric status can be alleviated.

• #1

  https://journals.lww.com/ajg/fulltext/2016/10001/chemical_prophylaxis_to_prevent_dvt_in_patients.114.aspx

  Vascular complications in pancreatitis generally include hemorrhage or thrombosis. […] To identify if chemical DVT prophylaxis in pancreatitis is harmful to the patient by increasing the risk of hemorrhagic conversion of pancreatitis or the risk of peri-pancreatic hemorrhage or beneficial by preventing venous thrombosis in the abdominal vasculature surrounding the pancreas. […] 74.6 % of patients received chemical prophylaxis, mostly low molecular weight heparin. […] Only 12 patients (3%) had complications related to thrombosis and hemorrhage. […] Pearson coefficient showed no statistically significant correlation between incidence of complications and chemical DVT prophylaxis. […] Our study is the first of its kind to evaluate risk of bleeding/thrombosis with DVT prophylaxis but does not show an increased risk.

• #1 No evidence for the benefit of PPIs in the treatment of acute pancreatitis: a systematic review and meta-analysis | Scientific Reports

  https://www.nature.com/articles/s41598-023-29939-5

  Although current guidelines do not recommend the use of proton pump inhibitors (PPIs) in the standard of care of acute pancreatitis (AP), they are often prescribed in clinical practice, mainly for ulcer stress prophylaxis. […] The use of PPIs for the treatment of AP can be considered as an off-label indication; however, the usual indications of PPIs may coincide with AP treatment. […] Two cohort studies reported significantly increased severity among AP cases in which PPIs were prescribed that may be associated with an increased mortality. […] PPI use in the treatment of AP is associated with a decreased risk of developing pancreatic pseudocysts. However, there were no significant differences between the two groups in terms of 7-day mortality, length of hospital stay, and ARDS incidence rates. Furthermore, we found an increased risk of bleeding in the PPI group. […] The prophylactic use of PPIs for stress ulcer prophylaxis in individuals with AP is an off-label indication. […] PPIs should be recommended only as an addition to the standard of care, if there is a relevant comorbidity or a higher risk for GI bleeding or developing pancreatic pseudocyst.

• #1 Global epidemiology and holistic prevention of pancreatitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6597260/

  Although time from an episode of pancreatitis to developing its sequelae varies in the published studies, there is clearly a large window of opportunity for their prevention. For example, two large studies investigated factors associated with post-pancreatitis diabetes mellitus (PPDM). […] The holistic prevention of pancreatitis (HPP) concept postulates that primary, secondary and tertiary prevention strategies need to be systematically employed to lessen the effect of pancreatitis and its sequelae.

• #1 Pancreatitis – symptoms, causes and treatment | healthdirect

  https://www.healthdirect.gov.au/pancreatitis

  Can pancreatitis be prevented? […] Depending on the cause of your pancreatitis, there may be ways to you can prevent pancreatitis from recurring. […] You may need to reduce your intake of fatty foods and to eat a healthy diet. This is especially important if the cause was gallstones and your gallbladder has not been removed. Drinking plenty of clear fluid, like water, will also help prevent another episode. […] If the cause of your pancreatitis was alcohol, you will need to stop drinking completely to avoid recurrence. […] If you smoke, quitting can also help.

• #1 How to Lower Your Risk of Future Pancreatitis Attacks

  https://health.clevelandclinic.org/pancreatitis-how-to-lower-your-risk-of-future-attacks

  Stopping future pancreatitis attacks are possible. To start on a healthy journey, its important to make some behavioral and lifestyle changes. […] Successful management will involve multi-specialist care, including behavioral and lifestyle modification. […] Do what you can to lower these risk factors: […] If you are diagnosed with gallstones and have suffered an attack of pancreatitis, removing the gallbladder can help prevent future problems. […] Excessive alcohol intake causes up to 70% of chronic pancreatitis cases, and nearly half of acute pancreatitis, so it makes sense to stop drinking alcohol. […] It can make your outcomes worse, make the disease (chronic pancreatitis) progress faster and increase your risk of pancreatic cancer. […] Avoid high-fat foods, especially fried foods that can put a load on your digestive system. Instead, focus on eating a low-fat, high-protein diet that is rich in vitamins and nutrients. Patients with chronic pancreatitis often benefit from the institution of medium-chain triglyceride (MCT) oil in their diet. You may also consider taking artificial digestive enzymes, which help your body break down food and absorb nutrients and vitamins. Consult with your doctor about if artificial digestive enzymes would be a good idea to take.

• #1 Chronic Pancreatitis | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/chronic-pancreatitis.html

  The best way to prevent chronic pancreatitis is to drink only in moderation or not at all. Moderate alcohol drinking is considered to be no more than 1 drink per day for women and 2 drinks per day for men. Quitting smoking is also very helpful. It eases pain and swelling. […] If you have been diagnosed with chronic pancreatitis, your healthcare provider may suggest these lifestyle changes: […] Don’t drink alcoholic drinks. […] Don’t smoke. […] Stick to a healthy diet that’s low in fat and protein. […] Eat smaller and more frequent meals.

• #1 Pancreatitis Diet: Foods to Eat and Avoid

  https://www.healthline.com/health/pancreatitis-diet

  Always check with your doctor or dietitian before changing your eating habits when you have pancreatitis. Here are some tips they might suggest: Eat five to six small meals throughout the day to help recover from pancreatitis. […] With acute pancreatitis, you may want to avoid eating too much fiber at once. […] Some people with chronic pancreatitis may need to avoid a high-fiber diet. […] If youve been diagnosed with chronic pancreatitis, talk with your doctor or dietitian about monitoring your vitamin levels. Some people may need to take supplements if they are unable to absorb enough nutrients from their diet.

• #1 Chronic pancreatitis secondary prevention – wikidoc

  https://www.wikidoc.org/index.php/Chronic_pancreatitis_secondary_prevention

  Effective measures for the secondary prevention of Hereditary pancreatitis include low-fat diet, multiple small meals, good hydration, antioxidants and cessation/abstinence from smoking and alcohol use. […] Patients should be managed appropriately and timely with glucocorticoids and immunomodulatory drugs to prevent complications. […] Avoiding the following conditions may also prevent the recurrent episodes of acute pancreatitis: Alcohol and tobacco use, Dehydration, Physical and emotional stresses. […] Patients should be managed appropriately and timely with glucocorticoids and immunomodulatory drugs to prevent complications such as: Pancreatic insufficiency, Diabetes, Pancreatic calcifications or stones.

• #1 Pancreatitis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/8103-pancreatitis

  Not all causes are preventable, but you can reduce your risk by moderating your alcohol consumption. […] You can reduce your risk of gallstones, the other leading cause, by reducing cholesterol. […] If you’ve had acute pancreatitis, you can help prevent it from happening again by quitting alcohol and smoking. […] If you’ve had gallstone pancreatitis, removing your gallbladder can prevent it from recurring.

• #1 Lifestyle Medicine for the Prevention and Treatment of Pancreatitis and Pancreatic Cancer

  https://www.mdpi.com/2075-4418/14/6/614

  Lifestyle medicine is critical in understanding, preventing, and treating pancreatitis and pancreatic cancer. By focusing on the six pillars of lifestyle medicine, individuals can adopt healthy behaviors that promote their overall well-being and potentially reduce the risk or impact of these conditions. […] Lifestyle medicine employs evidence-based interventions to promote health through six key pillars: embracing a whole-food, plant-predominant dietary pattern; regular physical activity; ensuring restorative sleep; managing stress effectively; removing harmful substances; and fostering positive social connections. This review provides a comprehensive overview of lifestyle interventions for managing and preventing the development of pancreatitis and pancreatic cancer. […] The incidence of pancreatitis and pancreatic cancer is on the upswing in the USA. These conditions often lead to higher healthcare costs due to the complex nature of diagnosis and the need for specialized medical interventions, surgical procedures, and prolonged medical management.

• #1 Pancreatitis Diet: Foods to Eat/Avoid Plus Lifestyle Tips – Dr. Axe

  https://draxe.com/health/pancreatitis-diet/

  Not only is following a diet for pancreatitis necessary to help recover, but it is essential to help prevent this disease from entering the chronic phase. […] Light to moderate exercise, yoga and meditation can help manage the symptoms, and avoiding alcohol and tobacco is absolutely necessary for recovery. […] After a diagnosis of acute or chronic pancreatitis, nutrition must be the first priority. The goal with a pancreatitis diet is to prevent malnutrition, nutritional deficiencies and optimize blood sugar levels while protecting against kidney and liver problems, pancreatic cancer and worsening symptoms. […] Columbia University’s Pancreas Center recommends focusing on a nutrient-dense diet high in lean proteins, whole grains, fruits, vegetables and low-fat dairy products while avoiding greasy fried foods and alcohol.

• #1 Lifestyle Medicine for the Prevention and Treatment of Pancreatitis and Pancreatic Cancer

  https://www.mdpi.com/2075-4418/14/6/614

  Increasing evidence underscores the importance of a healthy lifestyle in preventing and managing these conditions. […] Epidemiological studies show a strong association between PDAC and inflammatory stimuli. Studies of dietary patterns and cancer outcomes suggest that diet and lifestyle changes might influence an individual’s risk of PDAC by modulating metabolic fluctuations and inflammation. […] With the difficulty of diagnosis and low survival rate of pancreatic cancer, prevention with lifestyle medicine may be the best way to reduce the incidence of pancreatic cancer. […] By adopting these lifestyle measures, individuals can reduce their exposure to triggers that stimulate inflammation, which can contribute to the development of pancreatitis and pancreatic adenocarcinoma. Moreover, such lifestyle changes can improve the overall quality of life while limiting the risk of chronic diseases. Further research focusing on these aspects of lifestyle medicine and their impact on preventing pancreatitis and pancreatic cancer in order to better understand their effectiveness and develop more targeted interventions is highly recommended.

• #2 Global epidemiology and holistic prevention of pancreatitis | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/s41575-018-0087-5

  Knowledge of pancreatitis in the 20th century was shaped predominantly by animal data and clinical trials. […] Furthermore, the article introduces a framework for the holistic prevention of pancreatitis with a view to providing guidance on strategies and intervention objectives at primary, secondary and tertiary levels. […] The holistic prevention of pancreatitis (HPP) concept postulates that primary, secondary and tertiary prevention strategies need to be systematically employed to lessen the effect of pancreatitis and its sequelae.

• #2 Lifestyle Medicine for the Prevention and Treatment of Pancreatitis and Pancreatic Cancer

  https://www.mdpi.com/2075-4418/14/6/614

  Lifestyle medicine is critical in understanding, preventing, and treating pancreatitis and pancreatic cancer. By focusing on the six pillars of lifestyle medicine, individuals can adopt healthy behaviors that promote their overall well-being and potentially reduce the risk or impact of these conditions. […] Lifestyle medicine employs evidence-based interventions to promote health through six key pillars: embracing a whole-food, plant-predominant dietary pattern; regular physical activity; ensuring restorative sleep; managing stress effectively; removing harmful substances; and fostering positive social connections. This review provides a comprehensive overview of lifestyle interventions for managing and preventing the development of pancreatitis and pancreatic cancer. […] The incidence of pancreatitis and pancreatic cancer is on the upswing in the USA. These conditions often lead to higher healthcare costs due to the complex nature of diagnosis and the need for specialized medical interventions, surgical procedures, and prolonged medical management.

• #2 Pancreatitis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/8103-pancreatitis

  Not all causes are preventable, but you can reduce your risk by moderating your alcohol consumption. […] You can reduce your risk of gallstones, the other leading cause, by reducing cholesterol. […] If you’ve had acute pancreatitis, you can help prevent it from happening again by quitting alcohol and smoking. […] If you’ve had gallstone pancreatitis, removing your gallbladder can prevent it from recurring.

• #2 Pancreatitis – What causes pancreatitis? | familydoctor.org

  https://familydoctor.org/condition/pancreatitis/

  You can’t prevent pancreatitis, but there are steps you can take to reduce the risk that you will develop it. These include: […] Maintain a healthy lifestyle or lose weight, if needed. By keeping your body at a healthy weight, you can make your pancreas work better and reduce some risk factors for pancreatitis. These include gallstones, obesity, and diabetes. Eat a balanced, low-fat diet and exercise regularly. […] Avoid alcohol. Heavy alcohol use is one of the leading causes of both acute and chronic pancreatitis. Talk to your doctor if you need help to stop drinking. […] Don’t smoke. Smoking is a risk factor for pancreatitis. Your risk goes up even more if you smoke and drink alcohol. Talk to your doctor if you need help to stop smoking.

• #2

  https://www.nhs.uk/conditions/acute-pancreatitis/prevention/

  Acute pancreatitis is often caused by gallstones or drinking too much alcohol. A healthy lifestyle can reduce your chances of developing the condition. […] The most effective way of preventing gallstones is by eating a balanced diet that includes at least 5 portions of fresh fruit and vegetables a day. […] You can reduce your risk of developing acute pancreatitis by cutting back on drinking alcohol. This helps to prevent your pancreas being damaged. […] Remember, if you’ve had acute pancreatitis caused by drinking too much alcohol, you should avoid it completely.

• #2 What Is Pancreatitis? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/pancreatitis/guide/

  Making certain lifestyle modifications can help reduce your risk for pancreatitis. This includes: […] Limiting Alcohol Consumption This might even mean cutting it out entirely. The most common cause of acute pancreatitis is excessive alcohol consumption, and chronic pancreatitis most commonly is due to alcoholism. […] Eating a Low-Fat Diet Avoiding fatty and fried foods can reduce your risk for gallstones, a leading cause of acute pancreatitis. High levels of triglycerides can also increase your risk for acute pancreatitis. Limiting foods high in simple sugars (sweets, sugary sodas) can help. […] Exercising Regularly Being overweight increases your risk of gallstones, which puts you at greater risk for pancreatitis. But avoid crash diets, which can cause your liver to increase cholesterol production, which in turn increases your risk for gallstones. […] Not Smoking Adults who smoked were 1.5 times more likely to develop acute or chronic pancreatitis than nonsmokers, according to a 2019 review.

• #2 Prevention of ERCP-induced Pancreatitis | Pancreapedia

  https://pancreapedia.org/reviews/prevention-of-ercp-induced-pancreatitis

  Pancreatitis is a common, costly, and occasionally devastating complication of endoscopic retrograde cholangiopancreatography (ERCP). Since post-ERCP pancreatitis (PEP) is important and potentially preventable, a comprehensive approach to risk reduction should be employed by all who perform ERCP. Strategies to reduce the incidence of PEP, which should be considered in every case, include thoughtful patient selection, risk-stratification, sound procedural technique, prophylactic pancreatic stent placement, and pharmacoprevention. […] Given the magnitude of this problem, prevention of PEP remains a major clinical and research priority. […] Since PEP is potentially preventable, a comprehensive approach to risk reduction should be employed by all who perform ERCP. Preventive strategies can be broadly divided into 5 areas: (1) appropriate patient selection, (2) risk stratification of patients undergoing ERCP and meaningful use of this information in clinical decision-making, (3) atraumatic and efficient procedural technique, (4) prophylactic pancreatic stent placement, and (5) pharmacoprevention.

• #2 Prevention and Management of Post-ERCP Pancreatitis

  https://www.primescholars.com/articles/prevention-and-management-of-postercp-pancreatitis-97377.html

  Pancreatitis remains as one of the most frequent and serious complications of ERCP. […] Recent studies have had a major impact on both procedural techniques and pharmacological methods for prophylaxis of post-ERCP pancreatitis. […] The primary aim of this article will be to review the recent advances in prevention and management of PEP. […] The best approach to preventing PEP is to avoid performing ERCP in patients with marginal indications. […] Pancreatic duct stents have been increasingly used in recent years for prevention of PEP. […] Prophylactic stenting of the pancreatic duct has been shown to decrease the risk of PEP in several situations, including SOD, pre-cut sphincterotomy, balloon dilation of the biliary sphincter, ampullectomy, and pancreatic guidewire assisted cannulation of the bile duct.

• #2 Prevention of ERCP-induced Pancreatitis | Pancreapedia

  https://pancreapedia.org/reviews/prevention-of-ercp-induced-pancreatitis

  Despite these considerations, PSP is widely regarded as an effective means of preventing PEP, is commonly used in academic medical centers in the United States, and is recommended by the European Society of Gastrointestinal Endoscopy. […] Pharmacoprevention for PEP has been a major research priority in the last 3 decades. […] In the last decade, research focusing on rectal NSAIDs has provided renewed hope for pharmacoprevention. […] Despite this meta-analysis, however, NSAIDs were seldom used in clinical practice due to the absence of conclusive RCT evidence. […] Available data indicate that rectal NSAIDs are effective in addition to PSP in high-risk cases, but to date, there are no clinical trial data examining whether indomethacin is effective when administered instead of PSP. […] Despite the approaches outlined above, up to 15% of high-risk patients will still develop PEP. Appropriate patient selection, sound procedural technique, NSAIDs, and pancreatic stents have been effective in improving the problem, however additional research in multiple areas is necessary to achieve the goal of eliminating PEP.

• #2

  https://link.springer.com/article/10.1007/s10620-025-08870-x

  Post-ERCP pancreatitis (PEP) is a morbid complication of ERCP that occurs in up to 15% of high-risk patients. Prevention of PEP involves multiple factors; as a highly operator-dependent technique, prioritizing optimal procedural training is essential in addition to careful patient selection, judicious risk stratification, and the choice of the most effective technical and pharmacological strategies to achieve optimal patient outcomes. […] Though for most patients, prophylactic rectal non-steroidal anti-inflammatory drugs (NSAIDs) and aggressive hydration remain the cornerstone of PEP prophylaxis, for high-risk cases (e.g., difficult cannulation or prior PEP), additional strategies such as pancreatic stent placement or modifications in techniques (e.g., early use of needle-knife fistulotomy or other advanced cannulation methods) may be warranted.

• #2

  https://link.springer.com/article/10.1007/s10620-024-08565-9

  Despite ongoing debates, the latest recommendations from ASGE 2023 and ESGE 2019 strongly advocate for NSAID use in patients without contraindications. […] The 2023 ASGE guidelines recommend the perioperative use of NSAIDs as a preventive measure for PEP during ERCP. […] Current guidelines do not specify preferred NSAIDs. […] Thus, the current standard dose of 100 mg indomethacin or diclofenac remains safe and effective for PEP prevention, with no notable benefits from dosage adjustments observed. […] Collectively, NSAID monotherapy remains a potent, cost-effective prophylactic option against PEP, especially in patients without heightened risk factors. […] Preventing PEP with NSAIDs is cost-beneficial for all patients, especially in countries with low-cost NSAIDs.

• #2 SciELO Brazil – POST ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY PANCREATITIS PROPHYLAXIS: EVALUATION OF TWO DIFFERENT NSAID REGIMENS POST ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY PANCREATITIS PROPHYLAXIS: EVALUATION OF TWO DIFFERENT NSAID REGIM

  https://www.scielo.br/j/ag/a/kprGLSxPBbb6cgr5f3TjcDv/

  Post-endoscopic retrograde cholangiopancreatography pancreatitis occurred in 4.39% (12/273) of the participants. […] This study provides evidence for the efficacy of non-steroidal anti-inflammatory drugs in the prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis. […] The preventive methods include mechanical and pharmacological approaches, such as the use of non-steroidal anti-inflammatory drugs. […] Following the ESGE guidelines, 100 mg rectal diclofenac is used in Brazil to prevent PEP. […] For the prevention of PEP, 100 mg rectal diclofenac or 100 mg intravenous ketoprofen was administered to the patients following the ESGE guidelines. […] Despite the non-significant difference when the two therapeutic groups were separately analyzed, the joint analysis revealed that patients receiving prophylaxis had decreased incidence of PEP when compared with the control group.

• #2 Prevention and Management of Post-ERCP Pancreatitis

  https://www.primescholars.com/articles/prevention-and-management-of-postercp-pancreatitis-97377.html

  Rectally administered indomethacin should be considered if any risk factor for PEP is present. […] Although data is limited, prophylactic aggressive fluid hydration with lactated Ringers solution can be considered in all patients with intact papillae who are not at risk of fluid overload. […] Future research is necessary to determine the optimal combination of current prophylactic agents and for discovery of new methods to prevent PEP.

• #2 Nafamostat for Prophylaxis against Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis Compared with Gabexate

  https://www.gutnliver.org/journal/view.html?volume=3&number=3&spage=205

  The incidences of acute pancreatitis and hyperamylasemia were 9.1% and 40.9%, respectively, in the nafamostat-treated group, and 8.6% and 39.4% in the gabexate-treated group. The frequencies of post-ERCP pancreatitis and hyperamylasemia did not differ significantly between the two groups, Post-ERCP pancreatitis in two group did not vary according to the different ERCP procedures. The mean serum amylase level at 6 h after ERCP was significantly lower in the nafamostat-treated group than in the gabexate-treated group (p=0.020). However, the difference in serum amylase level did not persist at 18 h and 36 h post-ERCP. […] Administration of nafamostat before ERCP was not inferior to gabexate in protecting against the development of pancreatitis. […] Endoscopic retrograde cholangiopancreatography (ERCP) is an important procedure for the diagnosis and treatment of biliary and pancreatic conditions. Prospective studies show that acute pancreatitis occurs in 3-17% of cases following the ERCP and that the post-ERCP pancreatitis (PEP) is associated with substantial morbidity, and even with mortality. Although PEP in most cases are mild, 10% of cases progress to severe pancreatitis, resulting in prolonged hospital stays and life-threatening consequences.

• #2 Antibiotic therapy for prophylaxis against infection of pancreatic necrosis in acute pancreatitis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/20464721/

  Pancreatic necrosis may complicate severe acute pancreatitis, and is detectable by computed tomography (CT). If it becomes infected mortality increases, but the use of prophylactic antibiotics raises concerns about antibiotic resistance and fungal infection. […] To determine the efficacy and safety of prophylactic antibiotics in acute pancreatitis complicated by CT proven pancreatic necrosis. […] No benefit of antibiotics in preventing infection of pancreatic necrosis or mortality was found, except for when imipenem (a beta-lactam) was considered on its own, where a significantly decrease in pancreatic infection was found. None of the studies included in this review were adequately powered. Further better designed studies are needed if the use of antibiotic prophylaxis is to be recommended.

• #2 Antibiotic Prophylaxis in Severe Acute Pancreatitis: Do We Need M

  https://www.primescholars.com/articles/antibiotic-prophylaxis-in-severe-acute-pancreatitis-do-we-need-more-metaanalytic-studies-98167.html

  Overall, there was no protective effect of antibiotic treatment with respect to mortality. With respect to morbidity, antibiotic prophylaxis did not protect against infected necrosis or surgical intervention. […] There was, however, an apparent benefit as regards nonpancreatic infections, with a relative risk reduction of 40%, absolute risk reduction of 15%, and number needed to treat of 7. […] In fact, results from a recent randomized trial, showing a significant reduction in extrapancreatic sepsis by starting antibiotic prophylaxis on admission to hospital, support this hypothesis. […] In conclusion, we do not need more meta-analytic studies on this topic; on the contrary, additional and well-carried out studies are required to explore the benefits of antibiotic prophylaxis in severe acute pancreatitis, also taking into account the adverse effects, the effects of the varying duration of the therapy, and whether the outcome of the infection is related to the etiology.

• #2 Timing of Antibiotic Prophylaxis in Acute Pancreatitislogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/jg200609010000001/2006/09/01/timing-antibiotic-prophylaxis-acute-pancreatitis

  Immediate antibiotic prophylaxis is recommended for patients with diagnosed pancreatic necroses (J Gastroenterol Hepatol 2002; 17(suppl):S15). […] A substantial number of patients will be treated inappropriately with antibiotics (in this study, 57%) if therapy is started on recognition of disease, before a CECT scan is completed, but other factors that predict necrosis, such as CRP levels, might help to lower this number. Patients should be given prophylactic antibiotics once severe pancreatitis is clinically suspected; however, antibiotics should be continued or stopped as soon as possible, based on CECT scan findings.

• #2 Is antibiotic prophylaxis beneficial in acute pancreatitis? – First update – Medwave

  https://www.medwave.cl/puestadia/resepis/6125.html?_view=en

  Antibiotic prophylaxis may reduce mortality and length of hospitalization in patients with acute pancreatitis, especially if administered early. […] Antibiotic prophylaxis may reduce mortality and length of hospitalization in patients with acute pancreatitis, but the certainty of the evidence is low. […] The probability of new evidence changing what we know is high. Any recommendation formulated at this moment should be reviewed in the light of new evidence.

• #2 Probiotic prophylaxis in patients with predicted severe acute pancreatitis (PROPATRIA): design and rationale of a double-blind, placebo-controlled randomised multicenter trial [ISRCTN38327949] | springermedizin.de

  https://www.springermedizin.de/probiotic-prophylaxis-in-patients-with-predicted-severe-acute-pa/9512772

  The primary outcome parameter 'total of infectious complications’, was chosen because it was shown in previous trials that also the number of pulmonary and urinary tract infections can be reduced by probiotics. […] PROPATRIA is a double-blind, placebo-controlled randomised multicenter trial that aims to show a reduction in infectious complications by the enteral use of a multispecies probiotics preparation in patients with predicted severe acute pancreatitis.

• #2 How to Lower Your Risk of Future Pancreatitis Attacks

  https://health.clevelandclinic.org/pancreatitis-how-to-lower-your-risk-of-future-attacks

  Stopping future pancreatitis attacks are possible. To start on a healthy journey, its important to make some behavioral and lifestyle changes. […] Successful management will involve multi-specialist care, including behavioral and lifestyle modification. […] Do what you can to lower these risk factors: […] If you are diagnosed with gallstones and have suffered an attack of pancreatitis, removing the gallbladder can help prevent future problems. […] Excessive alcohol intake causes up to 70% of chronic pancreatitis cases, and nearly half of acute pancreatitis, so it makes sense to stop drinking alcohol. […] It can make your outcomes worse, make the disease (chronic pancreatitis) progress faster and increase your risk of pancreatic cancer. […] Avoid high-fat foods, especially fried foods that can put a load on your digestive system. Instead, focus on eating a low-fat, high-protein diet that is rich in vitamins and nutrients. Patients with chronic pancreatitis often benefit from the institution of medium-chain triglyceride (MCT) oil in their diet. You may also consider taking artificial digestive enzymes, which help your body break down food and absorb nutrients and vitamins. Consult with your doctor about if artificial digestive enzymes would be a good idea to take.

• #2 Chronic Pancreatitis | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/chronic-pancreatitis.html

  The best way to prevent chronic pancreatitis is to drink only in moderation or not at all. Moderate alcohol drinking is considered to be no more than 1 drink per day for women and 2 drinks per day for men. Quitting smoking is also very helpful. It eases pain and swelling. […] If you have been diagnosed with chronic pancreatitis, your healthcare provider may suggest these lifestyle changes: […] Don’t drink alcoholic drinks. […] Don’t smoke. […] Stick to a healthy diet that’s low in fat and protein. […] Eat smaller and more frequent meals.

• #2

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abk6873

  Do not drink alcohol. It may make your pain worse and cause other problems, like making the swelling of your pancreas worse. Tell your doctor if you need help to quit. Counselling, support groups, and sometimes medicines can help you stay sober. […] Ask your doctor if you need to take pancreatic enzyme pills to help your body digest fat and protein. […] Eat a low-fat diet […] Limit fats and oils, such as butter, margarine, mayonnaise, and salad dressing, to no more than 1 tablespoon a meal. […] Avoid high-fat foods, such as: Chocolate, whole milk, ice cream, processed cheese, and egg yolks. […] Fried, deep fried, or buttered foods. […] Sausage, salami, and bacon. […] Cinnamon rolls, cakes, pies, cookies, and other pastries. […] Prepared snack foods, such as potato chips, nut and granola bars, and mixed nuts. […] Coconut and avocado. […] Fast food and convenience food meals that have lots of fat.

• #2 Pancreatitis Diet: Foods to Eat and Avoid

  https://www.healthline.com/health/pancreatitis-diet

  Always check with your doctor or dietitian before changing your eating habits when you have pancreatitis. Here are some tips they might suggest: Eat five to six small meals throughout the day to help recover from pancreatitis. […] With acute pancreatitis, you may want to avoid eating too much fiber at once. […] Some people with chronic pancreatitis may need to avoid a high-fiber diet. […] If youve been diagnosed with chronic pancreatitis, talk with your doctor or dietitian about monitoring your vitamin levels. Some people may need to take supplements if they are unable to absorb enough nutrients from their diet.

• #2 Pancreatitis Diet: Foods to Eat/Avoid Plus Lifestyle Tips – Dr. Axe

  https://draxe.com/health/pancreatitis-diet/

  If you smoke cigarettes or use other tobacco products, stop. […] Eat three to four small meals each day. […] Stay hydrated. Drink at least eight ounces of water per 10 pounds of body weight each day. […] Meditate, and practice relaxation to ease stress and pain. […] Practice yoga twice each week. According to a study published in the World Journal of Gastroenterology, yoga improves overall quality of life for those with chronic pancreatitis.

• #2 Pancreatitis diet: Best foods to eat and avoid

  https://www.medicalnewstoday.com/articles/320994

  A diet beneficial for pancreatitis may be rich in fruits, vegetables, beans and lentils, whole grains, lean meats, fish, and healthy fats such as medium-chain triglycerides (MCTs). […] Eating more fiber may lower the chances of developing gallstones and acute pancreatitis. […] Some research suggests that eating approximately 2 to 3 servings of fish per week may even help to prevent non-gallstone-related acute pancreatitis. […] According to the European Society for Clinical Nutrition and Metabolism (ESPEN), oral nutritional supplements containing medium-chain triglycerides (MCTs) may be helpful for some people with chronic pancreatitis. […] Obesity increases the risk for pancreatitis, so achieving and maintaining a healthy weight may help lower risk of developing pancreatitis. […] Drinking large amounts of alcohol and smoking also raise an individuals risk for pancreatitis, so cutting back or avoiding these can help with preventing the condition.

• #2 Acute Pancreatitis – Symptoms, Causes , Treatment & Prevention PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact Nu

  https://www.pacehospital.com/acute-pancreatitis-symptoms-causes-types-treatment-prevention

  Acute pancreatitis and recurrent episodes can be prevented by taking the following precautions: […] Reducing alcohol consumption […] Maintaining a healthy weight and avoiding obesity […] Quitting smoking […] Early Gallstone Treatment […] Dietary Adjustments (A diet low in fat) […] Acute pancreatitis can be prevented by limiting alcohol consumption, maintaining a healthy weight, consuming a balanced diet, quitting smoking, and managing conditions like high cholesterol and gallstones.

• #2 Pancreatitis Diet: Foods to Eat and Avoid

  https://www.healthline.com/health/pancreatitis-diet

  After acute pancreatitis, your doctor will usually recommend reducing your fat intake until your symptoms improve. […] If you consume alcohol, your doctor may recommend that you stop drinking after being diagnosed with pancreatitis. […] If you have pancreatitis, you will be advised to stop drinking alcohol completely. If you smoke, youll also be strongly advised to quit. This is because alcohol and tobacco are associated with serious complications of pancreatitis. […] While recovering from acute pancreatitis, youll likely focus on eating a low-fat diet that wont tax or inflame your pancreas. […] If you need to make long-term dietary changes because of pancreatitis, your doctor may refer you to a dietitian. […] When recovering from acute pancreatitis, your doctor will usually ask you to follow a special diet to help reduce pain and prevent the condition from returning.

• #2 Pancreatic Cancer Risk Factors | American Cancer Society

  https://www.cancer.org/cancer/types/pancreatic-cancer/causes-risks-prevention/risk-factors.html

  Chronic pancreatitis, a long-term inflammation of the pancreas, is linked with an increased risk of pancreatic cancer. Chronic pancreatitis is often seen with heavy alcohol use and smoking. […] Chronic pancreatitis is sometimes due to an inherited gene mutation. People with this inherited form of pancreatitis have a higher lifetime risk of pancreatic cancer.

• #2 LIFEStyle, Prevention and Risk of Acute PaNcreatitis (LIFESPAN): protocol of a multicentre and multinational observational case–control study | BMJ Open

  https://bmjopen.bmj.com/content/10/1/e029660

  In this study, our aim is to examine these health-affecting individual lifestyle factors that seem to influence the development and outcome. […] We hope to find both negative and positive associations which will allow for the first time to suggest lifestyle modifications for patients discharged from the hospitals after AP or for those who wish to reduce their risk for AP.

• #3 LIFEStyle, Prevention and Risk of Acute PaNcreatitis (LIFESPAN): protocol of a multicentre and multinational observational case–control study | BMJ Open

  https://bmjopen.bmj.com/content/10/1/e029660

  Acute pancreatitis (AP) is a life-threatening inflammatory disease of the exocrine pancreas which needs acute hospitalisation. Despite its importance, we have significant lack of knowledge concerning whether lifestyle factors elevate or decrease the risk of AP or influence the disease outcome. This insufficient information is even more problematic since (1) there is no specific treatment for the disease, therefore prevention would be very important; and (2) 20% of all AP is recurrent so lifestyle suggestions decreasing the risk of an additional attack could be highly efficient. […] Accordingly, LIFESPAN identifies risk factors of acute pancreatitis and helps to prepare preventive recommendations for lifestyle elements. […] Innovative results are to be expected concerning that contribution of lifestyle factors to acute pancreatitis is poorly researched and known; therefore, evidence-based preventive suggestions might be carried out.

• #3 How to Lower Your Risk of Future Pancreatitis Attacks

  https://health.clevelandclinic.org/pancreatitis-how-to-lower-your-risk-of-future-attacks

  Stopping future pancreatitis attacks are possible. To start on a healthy journey, its important to make some behavioral and lifestyle changes. […] Successful management will involve multi-specialist care, including behavioral and lifestyle modification. […] Do what you can to lower these risk factors: […] If you are diagnosed with gallstones and have suffered an attack of pancreatitis, removing the gallbladder can help prevent future problems. […] Excessive alcohol intake causes up to 70% of chronic pancreatitis cases, and nearly half of acute pancreatitis, so it makes sense to stop drinking alcohol. […] It can make your outcomes worse, make the disease (chronic pancreatitis) progress faster and increase your risk of pancreatic cancer. […] Avoid high-fat foods, especially fried foods that can put a load on your digestive system. Instead, focus on eating a low-fat, high-protein diet that is rich in vitamins and nutrients. Patients with chronic pancreatitis often benefit from the institution of medium-chain triglyceride (MCT) oil in their diet. You may also consider taking artificial digestive enzymes, which help your body break down food and absorb nutrients and vitamins. Consult with your doctor about if artificial digestive enzymes would be a good idea to take.

• #3 What Is Pancreatitis? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/pancreatitis/guide/

  Making certain lifestyle modifications can help reduce your risk for pancreatitis. This includes: […] Limiting Alcohol Consumption This might even mean cutting it out entirely. The most common cause of acute pancreatitis is excessive alcohol consumption, and chronic pancreatitis most commonly is due to alcoholism. […] Eating a Low-Fat Diet Avoiding fatty and fried foods can reduce your risk for gallstones, a leading cause of acute pancreatitis. High levels of triglycerides can also increase your risk for acute pancreatitis. Limiting foods high in simple sugars (sweets, sugary sodas) can help. […] Exercising Regularly Being overweight increases your risk of gallstones, which puts you at greater risk for pancreatitis. But avoid crash diets, which can cause your liver to increase cholesterol production, which in turn increases your risk for gallstones. […] Not Smoking Adults who smoked were 1.5 times more likely to develop acute or chronic pancreatitis than nonsmokers, according to a 2019 review.

• #3 Medications and Methods for the Prevention of Post-ERCP Pancreatitis – Gastroenterology & Hepatology

  https://www.gastroenterologyandhepatology.net/archives/march-2017/medications-and-methods-for-the-prevention-of-post-ercp-pancreatitis/

  The risk of failed placement of a pancreatic duct stent is quite high and is associated with a markedly increased risk of post-ERCP pancreatitis. […] The optimal size and length of pancreatic duct stents to reduce the risk of post-ERCP pancreatitis has not been clearly determined. […] In the absence of more conclusive data, I view the placement of prophylactic pancreatic duct stents and the use of rectal indomethacin as adjunctive and complementary means of potentially reducing the risk of post-ERCP pancreatitis, particularly in patients at increased risk for pancreatitis. […] The most important way to reduce the likelihood of post-ERCP pancreatitis is to use sound clinical judgment that involves performing ERCP only for appropriate indications (usually for therapeutic intent) and by using good endoscopic technique, which derives from proper training and sustained experience.

• #3 Prevention and Management of Post-ERCP Pancreatitis

  https://www.primescholars.com/articles/prevention-and-management-of-postercp-pancreatitis-97377.html

  Pancreatitis remains as one of the most frequent and serious complications of ERCP. […] Recent studies have had a major impact on both procedural techniques and pharmacological methods for prophylaxis of post-ERCP pancreatitis. […] The primary aim of this article will be to review the recent advances in prevention and management of PEP. […] The best approach to preventing PEP is to avoid performing ERCP in patients with marginal indications. […] Pancreatic duct stents have been increasingly used in recent years for prevention of PEP. […] Prophylactic stenting of the pancreatic duct has been shown to decrease the risk of PEP in several situations, including SOD, pre-cut sphincterotomy, balloon dilation of the biliary sphincter, ampullectomy, and pancreatic guidewire assisted cannulation of the bile duct.

• #3

  https://link.springer.com/article/10.1007/s10620-024-08565-9

  Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) remains the most frequent and severe complication following ERCP, elevating both patient suffering and healthcare costs, and posing challenges to the advancement of ERCP techniques. […] Empirical evidence supports the prophylactic use of nonsteroidal anti-inflammatory drugs (NSAIDs) in the prevention of PEP, especially in high-risk populations, as endorsed by both the American Society for Gastrointestinal Endoscopy (ASGE) and the European Society for Gastrointestinal Endoscopy (ESGE). […] The ASGE and the European Society for Gastrointestinal Endoscopy (ESGE) both highly recommend preoperative rectal NSAIDs for high-risk patients. […] In recent years, NSAID utilization has expanded to include unselected PEP patients due to their cost-effectiveness.

• #3 SciELO Brazil – POST ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY PANCREATITIS PROPHYLAXIS: EVALUATION OF TWO DIFFERENT NSAID REGIMENS POST ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY PANCREATITIS PROPHYLAXIS: EVALUATION OF TWO DIFFERENT NSAID REGIM

  https://www.scielo.br/j/ag/a/kprGLSxPBbb6cgr5f3TjcDv/

  The incidence of PEP decreased from 10% to 1.3% with the use of intravenous ketoprofen and from 10% to 0% with the use of rectal diclofenac. […] Our study provides new evidence that the use of NSAIDs reduces the severity or even the number of PEP events described in other studies. […] The currently accepted hypotheses for the mechanism and pathophysiology of PEP are as follows: […] NSAIDs are known to be potent inhibitors of the PLA2 enzyme (elevated in pancreatitis), thus interrupting the inflammatory cascade in pancreatitis. […] Diclofenac is a non-selective cyclooxygenase 1 (COX1) and COX2 inhibitor with a safe profile, mainly in terms of gastrointestinal complications and toxicity. […] Routine administration of rectal diclofenac before or after ERCP has been recommended by European and Japanese society guidelines to minimize the risk of PEP.

• #3 Nafamostat for Prophylaxis against Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis Compared with Gabexate

  https://www.gutnliver.org/journal/view.html?volume=3&number=3&spage=205

  Several attempts have been made to minimize the occurrence and severity of PEP; identifying high-risk patients, developing less traumatic endoscopic interventions to limit pancreatic injury, and finding effective pharmacologic agents to administer prophylactically before ERCP. The efficacy of such agents (somatostatin, octreotide, diclofenac, indomethacin, and gabexate mesylate) to reduce the risk of PEP had been studied extensively. […] Nafamostat has been used for the treatment of severe pancreatitis or prophylaxis against pancreatitis after endoscopic procedures, and no serious side effects were reported. However, nafamostat has scarcely been studied for the prophylaxis against post-ERCP pancreatitis. […] In conclusion, administration of nafamostat before ERCP was not inferior to gabexate in protecting against the development of pancreatitis. Further prospective randomized study would be performed to compare with placebo in the future.

• #3 Antibiotic Prophylaxis in Severe Acute Pancreatitis: Do We Need M

  https://www.primescholars.com/articles/antibiotic-prophylaxis-in-severe-acute-pancreatitis-do-we-need-more-metaanalytic-studies-98167.html

  Overall, there was no protective effect of antibiotic treatment with respect to mortality. With respect to morbidity, antibiotic prophylaxis did not protect against infected necrosis or surgical intervention. […] There was, however, an apparent benefit as regards nonpancreatic infections, with a relative risk reduction of 40%, absolute risk reduction of 15%, and number needed to treat of 7. […] In fact, results from a recent randomized trial, showing a significant reduction in extrapancreatic sepsis by starting antibiotic prophylaxis on admission to hospital, support this hypothesis. […] In conclusion, we do not need more meta-analytic studies on this topic; on the contrary, additional and well-carried out studies are required to explore the benefits of antibiotic prophylaxis in severe acute pancreatitis, also taking into account the adverse effects, the effects of the varying duration of the therapy, and whether the outcome of the infection is related to the etiology.

• #3 Prophylaxis and treatment with antibiotics or probiotics in acute pancreatitis | Pancreapedia

  https://pancreapedia.org/reviews/prophylaxis-and-treatment-with-antibiotics-or-probiotics-in-acute-pancreatitis

  Early in the disease course of necrotizing pancreatitis two treatment strategies have been suggested to prevent secondary infection of peripancreatic collections and pancreas necrosis: […] Prophylactic administration of antibiotics […] Probiotic prophylaxis is not recommended for the prevention of infectious complications in acute pancreatitis. (GRADE 1B, strong agreement) […] Intravenous antibiotic prophylaxis is not recommended for the prevention of infectious complications in acute pancreatitis. (GRADE 1B, strong agreement)

• #3 Chronic Pancreatitis | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/chronic-pancreatitis.html

  The best way to prevent chronic pancreatitis is to drink only in moderation or not at all. Moderate alcohol drinking is considered to be no more than 1 drink per day for women and 2 drinks per day for men. Quitting smoking is also very helpful. It eases pain and swelling. […] If you have been diagnosed with chronic pancreatitis, your healthcare provider may suggest these lifestyle changes: […] Don’t drink alcoholic drinks. […] Don’t smoke. […] Stick to a healthy diet that’s low in fat and protein. […] Eat smaller and more frequent meals.

• #3 Acute Pancreatitis Therapy and Prevention 急性胰腺炎治療及預防 | 衛教單張 – China Medical University Hospital

  https://www.cmuh.cmu.edu.tw/HealthEdus/Detail_EN?no=6978

  Once acute pancreatitis is diagnosed, early treatment should be provided to patients, including fluid resuscitation, pain relief, and nutritional support. […] Research reveals that the promotional education carried on patients with alcohol-induced pancreatitis in every 6 months can reduce the number of recurrence for pancreatitis in 2 years. […] Patients with minor biliary pancreatitis should receive cholecystectomy upon administration to hospital. […] For patients with severe condition, cholecystectomy should be postponed after the full absorption of inflammation and fluid to avoid infection. […] Patients who could not receive surgery shall receive endoscopic papillotomy to lower the recurrence rate since it could facilitate the gallstones with unobstructed discharge. […] Preventive stent placement and pre-incision are often recommended for the prevention of post-ERCP pancreatitis. The two analyses indicate that preventive placement of pancreatic stent can reduce the incidence rate of post-ERCP pancreatitis.

• #4 Acute Pancreatitis Therapy and Prevention 急性胰腺炎治療及預防 | 衛教單張 – China Medical University Hospital

  https://www.cmuh.cmu.edu.tw/HealthEdus/Detail_EN?no=6978

  Once acute pancreatitis is diagnosed, early treatment should be provided to patients, including fluid resuscitation, pain relief, and nutritional support. […] Research reveals that the promotional education carried on patients with alcohol-induced pancreatitis in every 6 months can reduce the number of recurrence for pancreatitis in 2 years. […] Patients with minor biliary pancreatitis should receive cholecystectomy upon administration to hospital. […] For patients with severe condition, cholecystectomy should be postponed after the full absorption of inflammation and fluid to avoid infection. […] Patients who could not receive surgery shall receive endoscopic papillotomy to lower the recurrence rate since it could facilitate the gallstones with unobstructed discharge. […] Preventive stent placement and pre-incision are often recommended for the prevention of post-ERCP pancreatitis. The two analyses indicate that preventive placement of pancreatic stent can reduce the incidence rate of post-ERCP pancreatitis.

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