Pancreatitis causes abdominal pain. Chronic pancreatitis is treated with pain killers and intravenous or oral feedings with supplements. The present study was done to see if medium-chain triglycerides and hydrolyzed peptides could reduce the pain with feedings in pancreatitis. (Hydrolyzed proteins are proteins split into their amino acids.)
All of the patients studied had a history of daily pain for 10 months in spite of a low fat diet. The pain went from the mid upper abdomen (epigastric) to the back. The pain was not relieved by high-dose pancreatic enzymes or by vitamin E.
Most oral feeding preparations contain long-chain triglycerides, which increase pancreatic pain and stimulate cholecystokinin (CCK) production by the pancreas. The connection between CCK levels and the pancreatic pain is unknown. Medium-chain triglycerides result in little CPK stimulation. The effect of hydrolyzed peptides on CCK production is unknown. Pancreatic enzymes reduce CCK levels. Antioxidants, such as glutathione and cysteine improve pancreatic pain. Vitamin E does not.
Blood CCK was evaluated in the patients 60 minutes after a meal. Three cans of enteral supplement were drunk, daily. Pain scores for pancreatitis patients on MCT and hydrolyzed proteins had pain scores reduced by 68.5%. They used fewer narcotics for pain. Patients on MCT and hydrolyzed protein showed only mild elevation of blood CCK levels following oral enteral feedings.
CONCLUSION: Oral formulas used in pancreatitis patients containing hydrolyzed proteins and medium-chain triglycerides minimally stimulate CCK production, reduce pancreatic pain and reduce narcotic use.
NOTE: Read about the relationship between obesity and prognosis in pancreatitis.
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