Management of pancreatitis

5th November 2018 by Louise Hudman

Management of pancreatitis

This is a new guideline from NICE on pancreatitis from Sep 2018. Most of it is aimed at secondary care, but there are a few things that are useful for us which I’ve outlined below.

Advice to give patients

  • Recovery can take up to 3 x as long as the hospital stay (which can itself be months).
  • Warn patients that alcohol can aggravate even non-alcohol related pancreatitis.
  • There is a link between smoking and chronic pancreatitis.
  • Consider the need for psychological support. Pancreatitis can have a big impact on quality of life.

GP follow up

  • Patients need an HbA1c every 6m (there is an 80% lifetime risk of diabetes after chronic pancreatitis).
  • Patients need a DEXA scan every 2 yrs.

Chronic pancreatitis

  • Beware of this as a cause of chronic or recurrent upper abdominal pain.
  • Patients have a high risk of malnutrition and malabsorption. Specialist centres should be monitoring regularly for this (every 12m in adults and every 6m in young people).
  • Neuropathic pain may be associated and should be treated in the same way that other neuropathic pain should. NICE has separate guidance on this.
  • Diabetes associated with chronic pancreatitis is termed Type 3c diabetes. The need for insulin should be assessed every 6m. It should be managed in the same way that other diabetes should be managed.
  • There is a higher risk of cancer in patients with hereditary pancreatitis; there is a 40% lifetime risk of pancreatic cancer.

NASGP e-Learning

Now you've read this article, record your learning here and we'll instantly send you an elegant PDF as a record of your learning.
  • Date Format: MM slash DD slash YYYY
  • Write at least two learning points.
  • One credit = one hour learning demonstrated by this reflective record; include the time it took to do this activity, plus the time to have a good old think about it and muse with colleagues, and to complete this form. e.g. 0.5 = half an hour.
  • Record any notes here for yourself or your appraiser - why not include a link to the blog, podcast or video for future reference.
  • About this article or form - this *won't* appear on the report we email back to you; it's to help _us_ improve.
    I give permission to allow the author, Dr Louise Hudman, access to my replies for the sole purpose of improving the quality of these articles.

Join

Join to view the rest of this content, as well as access all the benefits of joining NASGP.

Join

Login

Already a member? Login to view this content.

Login

Related content

"I was introduced to the local locum chambers several months ago when I made a career move from partnership. I now combine salaried and locum roles. The chambers provides helpful support, leadership, advice and governance and reduces professional isolation. This combination of support reassures me and helps me provide safe and consistent care to patients within the community . There is a useful, innovative online portal - LocumDeck - which helps me access local work and which has efficient systems for reconciliation of finance including pensions. I would highly recommend joining a locum chambers for any GPs starting out in the locum world ."

Dr Adrian Richardson

Dr Adrian Richardson

See the full list of features within our NASGP membership plans

Membership