PMID- 30938130
OWN - NLM
STAT- MEDLINE
DCOM- 20190826
LR  - 20190826
IS  - 1827-1669 (Electronic)
IS  - 0026-4806 (Linking)
VI  - 110
IP  - 5
DP  - 2019 Oct
TI  - Alcohol-related chronic exocrine pancreatic insufficiency: diagnosis and 
      therapeutic management. A proposal for treatment by the Italian Association for 
      the Study of the Pancreas (AISP) and the Italian Society of Alcohology (SIA).
PG  - 425-438
LID - 10.23736/S0026-4806.19.06043-9 [doi]
AB  - Current estimates of the prevalence of chronic pancreatitis, one of the most 
      common causes of exocrine pancreatic insufficiency, are in the range of 3-10 per 
      100,000 people in many parts of the world. Alcohol consumption is a very 
      important risk factor for exocrine pancreatic insufficiency and is involved in 
      nearly half of all cases. The main hypothesis regarding the role of chronic 
      alcohol consumption in pancreatitis is that there must be additional 
      environmental or genetic risk factors involved for ongoing damage to occur. 
      Treatment of patients with alcohol-related exocrine pancreatic insufficiency is 
      complex, as the patient has two concomitant pathologies, alcohol-use disorder 
      (AUD) and exocrine pancreatic insufficiency/chronic pancreatitis. Alcohol 
      abstinence is the starting point for treatment, although even this along with the 
      most advanced therapies allow only a slowdown in progression rather than 
      restoration of function. This position paper of the Italian Association for the 
      Study of the Pancreas and the Italian Society of Alcohology provides an overview 
      of the pathogenesis of alcohol-related pancreatitis and discuss diagnostic 
      issues. Treatment options for both exocrine pancreatic insufficiency/chronic 
      pancreatitis (with a focus on pancreatic enzyme replacement therapy) and AUD 
      (acamprosate, disulfiram, oral naltrexone, long-acting injectable naltrexone, 
      sodium oxybate, nalmefene, baclofen, and psychosocial interventions) are also 
      reviewed.
FAU - Pezzilli, Raffaele
AU  - Pezzilli R
AD  - Pancreas Unit, Department of Gastroenterology, Polyclinic of Sant'Orsola, 
      Bologna, Italy - raffaele.pezzilli@aosp.bo.it.
AD  - Italian Association for the Study of the Pancreas, Rome, Italy - 
      raffaele.pezzilli@aosp.bo.it.
FAU - Caputo, Fabio
AU  - Caputo F
AD  - Department of Internal Medicine, SS. Annunziata Hospital, Cento, Ferrara, Italy.
AD  - G. Fontana Center for the Study and Multidisciplinary Treatment of Alcohol 
      Addiction, Department of Medical and Surgical Sciences, University of Bologna, 
      Bologna, Italy.
FAU - Testino, Gianni
AU  - Testino G
AD  - Regional Alcohol Center of Liguria Region, ASL3, San Martino Hospital, Genoa, 
      Italy.
FAU - Patussi, Valentino
AU  - Patussi V
AD  - Department of Alcohology, Hospital of Florence, Florence, Italy.
FAU - Greco, Giovanni
AU  - Greco G
AD  - Department of Mental Health and Pathological Dependency, AUSL Romagna, SerT 
      Ravenna, Ravenna, Italy.
FAU - Maccio, Livia
AU  - Maccio L
AD  - Alcohol Unit, ASL2 Savonese, Savona, Italy.
FAU - Rossin, Maria Raffaella
AU  - Rossin MR
AD  - ASST Fatebenefratelli, Sacco Hospital, Milan, Italy.
FAU - Mioni, Davide
AU  - Mioni D
AD  - Casa di Cura Parco dei Tigli, Villa Di Teolo, Padua, Italy.
FAU - Balbinot, Patrizia
AU  - Balbinot P
AD  - Regional Alcohol Center of Liguria Region, ASL3, San Martino Hospital, Genoa, 
      Italy.
FAU - Gandin, Claudia
AU  - Gandin C
AD  - National Observatory on Alcohol, National Institute of Health, Rome, Italy.
FAU - Zanesini, Francesca
AU  - Zanesini F
AD  - Private Practitioner, Genoa, Italy.
FAU - Frulloni, Luca
AU  - Frulloni L
AD  - Department of Medicine, Pancreas Institute, University of Verona, Verona, Italy.
FAU - Arico, Sarino
AU  - Arico S
AD  - Unit of Gastroenterology, Mauriziano Hospital, Turin, Italy.
FAU - Bottaro, Luigi C
AU  - Bottaro LC
AD  - ASL 3 Genovese, Genoa, Italy.
FAU - Pellicano, Rinaldo
AU  - Pellicano R
AD  - Unit of Gastroenterology, Molinette Hospital, Turin, Italy.
FAU - Scafato, Emanuele
AU  - Scafato E
AD  - National Observatory on Alcohol, National Institute of Health, Rome, Italy.
CN  - Italian Society of Alcohology (SIA)
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20190401
PL  - Italy
TA  - Minerva Med
JT  - Minerva medica
JID - 0400732
RN  - 0 (Alcohol Deterrents)
RN  - 0 (Antioxidants)
RN  - 3K9958V90M (Ethanol)
SB  - IM
MH  - Alcohol Abstinence
MH  - Alcohol Deterrents/therapeutic use
MH  - Alcoholism/complications/drug therapy/therapy
MH  - Antioxidants/therapeutic use
MH  - Disease Management
MH  - Disease Progression
MH  - Enzyme Replacement Therapy
MH  - Ethanol/*adverse effects
MH  - Exocrine Pancreatic Insufficiency/chemically induced/diagnosis/*etiology/therapy
MH  - Female
MH  - Humans
MH  - Life Style
MH  - Male
MH  - Oxidation-Reduction
MH  - Pancreatic Neoplasms/etiology
MH  - Pancreatitis, Alcoholic/*complications/diagnosis
MH  - Psychotherapy
MH  - Risk Factors
MH  - Self-Help Groups
FIR - Allosio, Pierluigi
IR  - Allosio P
FIR - Amendola, Maria Francesca
IR  - Amendola MF
FIR - Meneguzzi, Cristina
IR  - Meneguzzi C
FIR - Palmieri, Vincenzo O
IR  - Palmieri VO
FIR - Renzetti, Doda
IR  - Renzetti D
FIR - Vignoli, Teo
IR  - Vignoli T
EDAT- 2019/04/03 06:00
MHDA- 2019/08/27 06:00
CRDT- 2019/04/03 06:00
PHST- 2019/04/03 06:00 [pubmed]
PHST- 2019/08/27 06:00 [medline]
PHST- 2019/04/03 06:00 [entrez]
AID - S0026-4806.19.06043-9 [pii]
AID - 10.23736/S0026-4806.19.06043-9 [doi]
PST - ppublish
SO  - Minerva Med. 2019 Oct;110(5):425-438. doi: 10.23736/S0026-4806.19.06043-9. Epub 
      2019 Apr 1.