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Patients diagnosed with acute pancreatitis require hospital admission for treatment and to monitor their progress. There are no specific drugs to cure pancreatitis, but there are support measures to improve its evolution. These measures consist of the patient fasting to allow the pancreas to rest, administering abundant intravenous hydration and treating pain with analgesic drugs. In severe cases, specific treatment is provided according to the condition, such as vasoactive drugs in cases of shock and antibiotics for fever.
In chronic pancreatitis, the therapeutic goal is to control pain and treat exocrine and endocrine pancreatic insufficiency and complications. In a patient with abdominal pain, analgesic treatment should be started and complications that may cause pain should be ruled out. Analgesics recommended are paracetamol, tramadol, metamizole, gabapentin and, for very intense pain, opiods like MST morphine, oxycodone or buprenorphine. Opiods should be used under strict medical supervision, given their risk of causing dependence. When pain is not controlled with analgesics, endoscopic or surgical treatment can be considered.
Exocrine pancreatic insufficiency requires oral treatment of pancreatic enzymes and correction of nutritional deficits through vitamin and dietary supplements. Diabetes mellitus associated with chronic pancreatitis usually requires treatment with insulin.
Autoimmune pancreatitis can be treated very effectively with oral corticosteroids. In cases of recurrence, repeat treatment with corticosteroids or another immunosuppressant can be considered.
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