Consequences of chronic pancreatitis and exocrine pancreatic insufficiency, or When leaves fall from trees

Abstract

Aim. To analyze current literature data on the complications of chronic pancreatitis (CP) with exocrine pancreatic insufficiency (EPI).
 Main statements. According to statistical evidence, the presence of CP is associated with an increased risk of death, while the concomitant EPI significantly increases the risk of death. EPI is a big independent risk factor for death in patients with CP, which emphasizes the need for adequate correction of EPI in order to reduce mortality in this group.
 EPI is associated not only with an increase in mortality in CP patients but also with the development of various trophological defects. It has been stated that CP course is accompanied by a decrease in the level of albumin, malabsorption of fat-soluble vitamins (A, E, and D), carotenoids (beta-carotene, lycopene, cryptotaxin, and zeaxanthin), and the development of osteopenia and osteoporosis. CP course is linked to anxiety, depression, tumor pathology (pancreatic ductal adenocarcinoma, esophageal cancer, and stomach cancer), damage to the cardiovascular system, an increase in cardiovascular risk, and a high chance of myocardial infarction, stroke, and pancreatitis-induced thrombosis of the splenic vein. Modern enzyme replacement therapy makes it possible to compensate for some of the consequences of chronic EPI, reduce numerous signs of malnutrition, normalize the body mass index, and improve the quality of life of CP patients with EPI.