Camostat Mesilate, Pancrelipase, and Rabeprazole Combination Therapy Improves Epigastric Pain in Early Chronic Pancreatitis and Functional Dyspepsia with Pancreatic Enzyme Abnormalities (original) (raw)
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Research Articles| November 02 2018
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School, Tokyo, Japan
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Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School, Tokyo, Japan
Search for other works by this author on:
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School, Tokyo, Japan
Search for other works by this author on:
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School, Tokyo, Japan
Search for other works by this author on:
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School, Tokyo, Japan
Search for other works by this author on:
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School, Tokyo, Japan
Search for other works by this author on:
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School, Tokyo, Japan
Search for other works by this author on:
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School, Tokyo, Japan
Search for other works by this author on:
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School, Tokyo, Japan
Search for other works by this author on:
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School, Tokyo, Japan
Search for other works by this author on:
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School, Tokyo, Japan
Search for other works by this author on:
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School, Tokyo, Japan
Search for other works by this author on:
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School, Tokyo, Japan
Search for other works by this author on:
Digestion (2019) 99 (4): 283–292.
Received:
January 26 2018
Published Online:
November 02 2018
Citation
Hiroshi Yamawaki, Seiji Futagami, Keiko Kaneko, Shuhei Agawa, Kazutoshi Higuchi, Makoto Murakami, Mako Wakabayashi, Noriko Sakasegawa, Yasuhiro Kodaka, Nobue Ueki, Katya Gudis, Chiaki Kawamoto, Katsuhiko Iwakiri; Camostat Mesilate, Pancrelipase, and Rabeprazole Combination Therapy Improves Epigastric Pain in Early Chronic Pancreatitis and Functional Dyspepsia with Pancreatic Enzyme Abnormalities. _Digestion 28 May 2019; 99 (4): 283–292. https://doi.org/10.1159/000492813
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Abstract
Background/Aims: The aims of the study are to clarify the pathophysiological differences among early chronic pancreatitis (ECP), functional dyspepsia with pancreatic (FD-P) enzyme abnormalities and FD patients and to determine whether camostat mesilate, pancrelipase, and rabeprazole triple therapy improve FD symptoms in the ECP patients and FD-P patients in cross-over way. Methods: We enrolled 84 consecutive patients presenting with typical symptoms of FD patients (n = 42), ECP patients (n = 15), and FD-P patients (n = 27). Gastric emptying was assessed by the 13C-acetate breath test. ECP was diagnosed based on the criteria recommended by the Japan Pancreatic Association. Results: The proportions of female in ECP patients and FD-P were significantly higher compared to that in FD patients. The early phase of gastric emptying in ECP and FD-P patients was significantly disturbed compared to that in FD patients. The primary outcome of this study is that 4 weeks of camostat mesilate, pancrelipase, and rabeprazole triple therapy significantly ameliorated epigastric pain in ECP patients compared to acotiamide and rabeprazole combination therapy. Conclusion: Although there were no significant differences in pathophysiology between ECP patients and FD-P patients, triple therapy can significantly ameliorate epigastric pain in ECP patients. Further studies will be needed to clarify why triple therapy can improve epigastric pain in ECP patients.
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