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Authors: Mischuk V.G., Skoropad K.M.

Pages: 264-270


Alcohol abuse is the most common cause of chronic pancreatitis in Western countries, the disease is characterized by progressive damage of the pancreas which finally leads to a significant infringement of exo- and endocrine functions. In the pathogenesis of chronic pancreatitis distinguish direct toxic effects of alcohol and indirectly through pathologically modified digestive organs, including the liver. On the other hand, in alcoholic liver cirrhosis  often develop metabolic failure and dysregulation of energy metabolism, metabolism of carbohydrates, aminoacids, serum protein and coagulation factors synthesis, ammonia neutralization, biosynthesis of lipids and lipoproteins, bile acids occurs.

The purpose of research was to study the state exocrine pancreatic function, protein synthetic function of the liver and trofolohichnyy status in patients with chronic pancreatitis combined with alcoholic cirrhosis class A, B by Chald-Pugh.

It was examined 49 patients: 15 – with chronic alcoholic pancreatitis, 15 - with alcoholic cirrhosis class A, B by Chald-Pugh and 19 - with a combination of both diseases. Alcoholic etiology of diseases was based on medical history, previous medical records, including narcologists surveillance, questionnaires CAGE, MAST, scales Le Go. Anthropometric indicators scatological analysis, determining the activity of elastase and chymotrypsin in stool was carried out and the levels of total protein, prothrombin, cholinesterase were determined.

The study showed that the combination of these diseases occurred fairly significant disorder of exocrine pancreatic function that manifestated as a diarrhea, flatulence, steatorrhea, a more pronounced decrease in activity of chymotrypsin and elastase in the faeces. In particular, the chymotrypsin activity in feces of patients suffering from combined alcoholic liver disease and chronic alcoholic pancreatitis was 3.9 times lower compared with those of healthy people and elastase level was 1.8 times lower. Also, the comorbidity caused significantly decreased levels of total protein, albumin, cholinesterase. Somatometric indicators (shoulder circumference, thickness of subcutaneous fat folds, body mass index) were also reduced the most, in cases of combined alcohol-induced cirrhosis and pancreatitis compared with isolated chronic pancreatitis and cirrhosis.

Keywords:chronic alcoholic pancreatitis, alcoholic liver cirrhosis, exocrine pancreatic function, trophological status.

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  1. Witt H, Aple MV, Keim V et al. Chronic pancreatitis:  challenges and advances in pathogenesis, genetics, diagnosis and therapy. Gastroenterology. 2007; 132(4):1573-1577.
  2. Moiseev VSAlkogolnaiaboleznporazhzenievnutrennih [Alcoholicdiseaseinjurythe internal organs]. Moskva:GEOTAR-Media480 p.
  3. Buklis ER, Maevskaia MV, Ivashkin VT. [Liver cirrhosis: mechanisms of metabolic interruption and digestion failure, vicarious ferment therapy]. Klinicheskie perspektivy gastorenterologii, gepatologii.  2007; 3:13-18.
  4. Minushkin ON, Ardatskaia MD, Sergeev AV et al. [Study about contents of short-chain fatty acids of patients with chronic pancreatitis with pancreas exocrine insufficiency and without it].  Rus. Med. J.  2003; 6:35-37.
  5. Perederij VG, Tkach SM, Parunian LM. [Advantages and disadvantages of different methods for assessing exocrine pancreatic insufficiency]. Laboratorna diagnostyka. 2002;4:3-7.
  6. Whitcomb D. Mechanisms of disease advances in understanding the mechanisms leading to chronic pancreatitis Mat. Clin. Pract. Gastroenterol. Hepatol. 2004;1:46-52.
  7. Lopatkina TN. [Chronic pancreatitis: risk factors, prognosis and treatment]. Klinicheskaia farmakologiia i terapiia. 2005;14(5):21-23.
  8. Shcherbakov PL. [Question about pancreatitis]. Lechashchij vrach. 2011;7:20-24.
  9. Makhov VM. [Alcoholic liver disease and non-alcoholic liver disease - differences and similarities]. Lechashchij vrach. 2012;7:22-28.
  10. Banwell JG,.Leonard PJ and Rita MF Lobo. Measurment of tripsin and chymotripsin activity in stools to detect chronic pancreatic disease. Gut. 1965;6(143):143-145.
  11. Smith JS, Ediss I, Mullinger MA et al. Fekal chymotrypsin and tripsin determinations. C.M.A. Journal. 1971;April 17(104):691-697.
  12. Fedkiv O, Rengman S, Westrom BR et al. Growth is dependent on the exocrine pancreas function in young weaners but not in growing-finishing pigs. J. Physiol Pharmacol. 2009;60(3):55-59.
  13. BabinetsLSKvasnitskaOSMigenkoLMetal. [Trophologycdisordersinchronic pancreatitis and factors of their occurrence]. Visnyk naukovyh doslidzhzen. 2009;4:27-30.
  14. Belmer SV, Mitina EV, Anastasevych NA et al. [Trophological status and pancreatic enzymes]. Lechashchijvrach2012;1:26-29.
  15. Kishkun AARukovodstvopolaboratornymmetodamdiagnostiki [Guidance on laboratory dіagnostic methods]Moskva:GEOTAR-Media Publ.;2007.800p.
  16. Iagoda AV, Ushakova OV. [About indicators of pancreatic elastase in chronic viral liver diseases]. Izvestiia vysshyh uchebnyh zavedenij. Severo-Kavkazskij region. Estestvennye nauki. Aktualnye problem gastroenterologii.  2006; 90-91.
  17. Rapoport SI, Maev IV, Kucheriavyi AJU et al. [Experience in estimation of efficiency enzyme replacement therapy with microencapsulated pancreatin in severe primary pancreatic insufficiency using 13C-breath test]. Klinicheskaia2009;1:53-57.
  18. Gubina AV, Lazebnyk LB, Trubitsyna IE, inventors. Sposob diagnostiki hronicheskogo pankreatita alkogolnoi etiologii [Chronic pancreatitis alcoholic etiology diagnostic way]. Russian patent, no. 2320997. Retrieved from:
  19. Sun Gui-zhen, Li Qin, Ming Fu-yuan. A study of the clinical value of prealbumin, cholinesterase and total bile acids in the diagnostic of patients with chronic hepatitis B. Chin. J. Lab. Med. 2004;27(8):509-510.
  20. Maev IV, Kaziulin AN, Baranskaia EK. [Eating disorders as a causal factor in the development and worsening of pancreatitis]. Farmateka. 2011;12:38-45.