Practical guide to the management of chronic pancreatitis

Chronic pancreatitis (CP) is an irreversible fibroinflammatory disorder of the pancreas. It presents with relapsing, remitting upper abdominal pain accompanied by features of malabsorption due to pancreatic exocrine insufficiency and endocrine deficiency with the development of diabetes mellitus. The associated increased hospitalisation and high economic burden are related to CP often presenting at advanced stage with irreversible consequences. Diagnosing CP at an early stage is still challenging and therefore CP is believed to be under-reported. Our understanding of this disease has evolved over the last few years with attempts to redesign the definition of CP. Better recognition of the risk factors and conditions associated with CP can lead to an earlier diagnosis and coupled with a multidisciplinary approach to treatment, ultimately reduce complications. This article reviews the epidemiology, risk factors, diagnosis and management of CP.

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Endoscopy
Quality Improvement
British Society of Gastroenterology Endoscopic Retrograde Cholangiopancreatography (ERCP) Quality Improvement Programme: minimum service standards and good practice statements
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In 2014, the British Society of Gastroenterology (BSG) published a standards framework outlining key performance indicators for ERCP practitioners and services.

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Guidance
AGIP
AGIP Proposed Standardised Testing Protocol for Hydrogen/Methane Breath Testing (HMBT) to Assess Small Intestinal Bacterial Overgrowth (SIBO) and Carbohydrate Malabsorption
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This document was published in January 2019.