Heidi - re UpToDate article

[Guest guest]

Dear Heidi,

Last month you posted a link (or the entire article, I can't

remember)for this patient information sheet which I printed out and

have studied. I appreciate a new, comprehensive review of CP.

However, I have a concern:

Under the subheading of " What Are the Symptoms of Chronic

Pancreatitis " the 3rd paragraph states: " Symptoms of poor pancreatic

function (pancreatic insufficiency) do not occur until about 90

percent of pancreatic function has been lost. "

What worries me is that my doctor is under pressure (it's an HMO, of

course) that the prescription for Pancrease which is approx. $200/mo

is not substantiated by clinical/lab findings. My primary care

physician has diagnosed CP based on my reporting of symptoms mainly,

since nothing has shown up on CT, MRCP, or blood work since my initial

Acute Pancreatitis in 2001.

It was also interesting, with the personal experiences related on the

message board about stenting, that " Many studies suggest that stenting

is associated with an increase in the structural abnormalities

associated with pancreatitis. "

Thank you for sharing this information. Could you comment on the

benefit for enzyme supplementation BEFORE 90 percent of pancreatic

function has been lost?

Or anyone else have any comments about enzymes?

Thanks,

in Hawaii