This protocol targets patients with chronic pancreatitis in the compensated stage — a phase in which pancreatic function remains largely intact but abdominal pain and back pain dominate the clinical picture and drive management priorities.
The evidence-based first-line regimen centres on analgesic therapy as the initial approach to both abdominal and back pain, alongside a structured short-term dietary modification. The complete regimen — including further pharmacological measures and the full clinical algorithm — is available in the protocol.
Abdominal pain is the main symptom during the latent to compensatory stage, when there is no obvious impairment of pancreatic endocrine and exocrine function.
In the compensated stage, prevention of repeated relapses and pain takes priority.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first choice for analgesia, and if inadequate, weak opioids are useful for both abdominal pain and back pain.
A short-term low-fat diet (fat 30–35 g/day; fat ≤ 10 g/meal) is recommended for patients with compensatory abdominal pain and back pain.
We propose use of a proteolytic enzyme inhibitor as a treatment for pain.
A combination of camostat mesilate, pancrelipase, and rabeprazole has been reported to achieve significant improvement in epigastric pain in patients with early stage CP.
DOI: 10.1007/s00535-022-01911-6 View source ↗