Last year, the American College of Gastroenterology (ACG) published clinical guidelines to provide an evidence-based practical approach to the diagnosis and management of chronic pancreatitis for the general gastroenterologist. We, at Mission: Cure, commend the efforts of the authors and believe that these guidelines are an important step forward for pancreatitis patients who continue to seek a diagnosis and treatment plan while suffering with pain, hopelessness, and poor outcomes.
The clinical guidelines offer a systematic review of the literature to provide 11 recommendations that are accompanied with an assessment of the quality of evidence and strength of recommendation. These guidelines are notable for three reasons:
1. Draw attention to the origins of pancreatitis and the eventual consequences of the disorder.
The guidelines are based on the new mechanistic definition of pancreatitis that was published in 2016 and now adopted by major pancreas societies worldwide. Unlike the old definition, the new definition and the guidelines consider causes of pancreatitis, such as stress/injury and activation of the innate immune system, and create an urgency to prevent or delay the development of the disease, which is progressively debilitating if left unchecked.
2. Encourage a diagnosis process that integrates clinical symptoms, biomarkers, risk factors, and the exclusion of other diseases.
This multi-pronged approach is important because we know that relying on just one of these indicators often misses the diagnosis. Furthermore, guidelines recommend identification of factors contributing to pancreatic inflammation to predict progression of chronic pancreatitis, potential targets for therapies, and clinically relevant prognostic information.
3. Acknowledge the enormous burden of pain and digestive complications that accompany pancreatitis.
This is important because far too many times these symptoms are dismissed or overlooked along with the condition’s impact on mental wellbeing. The guidelines reference the limited and/or inconclusive research in these areas and provide a starting point on managing pain and exocrine pancreatic insufficiency for individuals suffering from CP.
To apply these clinical guidelines to deliver patient-centered care, we offer a simple framework that is designed to improve patient outcomes and well-being.
