Morphological and functional changes of chronic pancreatitis in patients with dyspepsia: A prospective, observational, cross-sectional study

• Published in: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2018-04, Vol.18 (3), p.280-285
• Main Authors: Lariño-Noia, José, de la Iglesia, Daniel, Iglesias-García, Julio, Macías, Fernando, Nieto, Laura, Bastón, Iria, Villalba, Carmen, Domínguez-Muñoz, J. Enrique
• Format: Article
• Language: English
• Subjects: Abdomen; Anorexia; Chronic pancreatitis (CP); Cross-sectional studies; Diabetes; Dyspepsia; Endoscopic pancreatic function test (ePFT); Endoscopic ultrasound (EUS); Endoscopy; Gastrointestinal diseases; Gender; Irritable bowel syndrome; Magnetic resonance cholangiopancreatography (sMRCP-MRI); Magnetic resonance imaging; Medical imaging; Morphology; Multivariate analysis; NMR; Nuclear magnetic resonance; Pain; Pain predominant dyspepsia (PPD); Pancreas; Pancreatic cancer; Pancreatitis; Risk factors; Smoking; Studies; Tobacco; Ulcers; Ultrasonic imaging; Ultrasound
• ISSN: 1424-3903; 1424-3911
• DOI: 10.1016/j.pan.2018.02.003

Whether chronic pancreatitis (CP) may present with dyspepsia is controversial. We aimed at evaluating the frequency and risk factors of changes of CP in patients presenting with epigastric pain syndrome (EPS)-like symptoms. A prospective, observational, cross-sectional study was carried out in patients with EPS-like symptoms. Patients underwent endoscopic ultrasound (EUS) evaluation of the pancreas, and changes of CP were defined as the presence of five or more EUS criteria of the disease. In patients with 3 or 4 EUS criteria, magnetic resonance dynamic evaluation of the pancreas (MRI/sMRCP) and endoscopic pancreatic function test (ePFT) were carried out to confirm or exclude the presence of changes of CP. A multivariate logistic regression analysis was performed to evaluate factors associated with CP findings, and results are shown as odds ratio (OR) and 95% confidence interval (CI). 213 patients were included. Changes of CP were confirmed by EUS (≥5 criteria) in 18 patients (8.4%). Thirty-four patients had 3-4 EUS criteria, and changes of CP were confirmed in 27 of them by MRI/sMRCP and ePFT (12.7%). Morphological and functional findings of CP were then present in 45 patients (21.1%). Male gender (OR 2.97; 95%CI 1.39–6.37) and alcohol and tobacco consumption (OR 6.56; 95%CI 1.97–21.85) were associated with the presence of changes of CP. Morphological and functional changes of CP are frequent in patients with EPS-like symptoms. Whether these pancreatic changes explain EPS-like symptoms requires further investigation.