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Assessment of Weight Loss and Gastrointestinal Symptoms Suggestive of Exocrine Pancreatic Dysfunction After Acute Pancreatitis

Studies evaluating the natural history of exocrine pancreatic dysfunction (EPD) after acute pancreatitis (AP) are sparse. This study aims to assess incidence and predictors of weight loss and gastrointestinal (GI) symptoms suggestive of EPD 12 months after an AP episode. METHODS: Patients enrolled i...

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Autores principales: Phillips, Anna Evans, Ooka, Kohtaro, Pothoulakis, Ioannis, Paragomi, Pedram, Komara, Nicole, Lahooti, Ali, Harb, Diala, Mays, Melanie, Koutroumpakis, Filippos, Stello, Kimberly, Greer, Phil J., Whitcomb, David C., Papachristou, Georgios I.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7743841/
https://www.ncbi.nlm.nih.gov/pubmed/33464001
http://dx.doi.org/10.14309/ctg.0000000000000283
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author Phillips, Anna Evans
Ooka, Kohtaro
Pothoulakis, Ioannis
Paragomi, Pedram
Komara, Nicole
Lahooti, Ali
Harb, Diala
Mays, Melanie
Koutroumpakis, Filippos
Stello, Kimberly
Greer, Phil J.
Whitcomb, David C.
Papachristou, Georgios I.
author_facet Phillips, Anna Evans
Ooka, Kohtaro
Pothoulakis, Ioannis
Paragomi, Pedram
Komara, Nicole
Lahooti, Ali
Harb, Diala
Mays, Melanie
Koutroumpakis, Filippos
Stello, Kimberly
Greer, Phil J.
Whitcomb, David C.
Papachristou, Georgios I.
author_sort Phillips, Anna Evans
collection PubMed
description Studies evaluating the natural history of exocrine pancreatic dysfunction (EPD) after acute pancreatitis (AP) are sparse. This study aims to assess incidence and predictors of weight loss and gastrointestinal (GI) symptoms suggestive of EPD 12 months after an AP episode. METHODS: Patients enrolled in the Pancreatitis-associated Risk of Organ Failure Study at the time of an AP episode were included. Weight and GI symptom data were prospectively collected by self-report at enrollment and at 3- and 12-month (windows 2–7 and 8–20) telephone follow-ups. Multivariable logistic regression was used to assess factors associated with ≥10% total body weight loss (EPD surrogate) at 12 months. A generalized estimating equation was used to measure each factor's population effect (in pounds) over 12 months after AP. RESULTS: Follow-up at 12 months in 186 patients (median age = 54 years, 46% men, 45% biliary, 65% first AP attack) revealed weight loss ≥10% from baseline, occurring in 44 patients (24%). Risk of weight loss increased with higher baseline body mass index, previous diagnosis of diabetes mellitus, and worsening AP severity (all P < 0.010). GI symptoms were reported in 13/31 (42%) patients at 12 months. AP severity was independently associated with ≥10% weight loss at 12 months. Over 12 months, men lost more weight than women (average 9.5 lbs); patients with severe AP lost, on average, 14 lbs. DISCUSSION: Weight loss after AP occurs in one-quarter of patients and is associated with AP severity. EPD incidence after AP is likely underappreciated. Further work is needed to assess EPD and potential for pancreatic enzyme supplementation.
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spelling pubmed-77438412020-12-17 Assessment of Weight Loss and Gastrointestinal Symptoms Suggestive of Exocrine Pancreatic Dysfunction After Acute Pancreatitis Phillips, Anna Evans Ooka, Kohtaro Pothoulakis, Ioannis Paragomi, Pedram Komara, Nicole Lahooti, Ali Harb, Diala Mays, Melanie Koutroumpakis, Filippos Stello, Kimberly Greer, Phil J. Whitcomb, David C. Papachristou, Georgios I. Clin Transl Gastroenterol Article Studies evaluating the natural history of exocrine pancreatic dysfunction (EPD) after acute pancreatitis (AP) are sparse. This study aims to assess incidence and predictors of weight loss and gastrointestinal (GI) symptoms suggestive of EPD 12 months after an AP episode. METHODS: Patients enrolled in the Pancreatitis-associated Risk of Organ Failure Study at the time of an AP episode were included. Weight and GI symptom data were prospectively collected by self-report at enrollment and at 3- and 12-month (windows 2–7 and 8–20) telephone follow-ups. Multivariable logistic regression was used to assess factors associated with ≥10% total body weight loss (EPD surrogate) at 12 months. A generalized estimating equation was used to measure each factor's population effect (in pounds) over 12 months after AP. RESULTS: Follow-up at 12 months in 186 patients (median age = 54 years, 46% men, 45% biliary, 65% first AP attack) revealed weight loss ≥10% from baseline, occurring in 44 patients (24%). Risk of weight loss increased with higher baseline body mass index, previous diagnosis of diabetes mellitus, and worsening AP severity (all P < 0.010). GI symptoms were reported in 13/31 (42%) patients at 12 months. AP severity was independently associated with ≥10% weight loss at 12 months. Over 12 months, men lost more weight than women (average 9.5 lbs); patients with severe AP lost, on average, 14 lbs. DISCUSSION: Weight loss after AP occurs in one-quarter of patients and is associated with AP severity. EPD incidence after AP is likely underappreciated. Further work is needed to assess EPD and potential for pancreatic enzyme supplementation. Wolters Kluwer 2020-12-15 /pmc/articles/PMC7743841/ /pubmed/33464001 http://dx.doi.org/10.14309/ctg.0000000000000283 Text en © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Article
Phillips, Anna Evans
Ooka, Kohtaro
Pothoulakis, Ioannis
Paragomi, Pedram
Komara, Nicole
Lahooti, Ali
Harb, Diala
Mays, Melanie
Koutroumpakis, Filippos
Stello, Kimberly
Greer, Phil J.
Whitcomb, David C.
Papachristou, Georgios I.
Assessment of Weight Loss and Gastrointestinal Symptoms Suggestive of Exocrine Pancreatic Dysfunction After Acute Pancreatitis
title Assessment of Weight Loss and Gastrointestinal Symptoms Suggestive of Exocrine Pancreatic Dysfunction After Acute Pancreatitis
title_full Assessment of Weight Loss and Gastrointestinal Symptoms Suggestive of Exocrine Pancreatic Dysfunction After Acute Pancreatitis
title_fullStr Assessment of Weight Loss and Gastrointestinal Symptoms Suggestive of Exocrine Pancreatic Dysfunction After Acute Pancreatitis
title_full_unstemmed Assessment of Weight Loss and Gastrointestinal Symptoms Suggestive of Exocrine Pancreatic Dysfunction After Acute Pancreatitis
title_short Assessment of Weight Loss and Gastrointestinal Symptoms Suggestive of Exocrine Pancreatic Dysfunction After Acute Pancreatitis
title_sort assessment of weight loss and gastrointestinal symptoms suggestive of exocrine pancreatic dysfunction after acute pancreatitis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7743841/
https://www.ncbi.nlm.nih.gov/pubmed/33464001
http://dx.doi.org/10.14309/ctg.0000000000000283
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