Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with recurrent epigastric pain radiating to the back, exacerbated by alcohol intake and fatty meals. Reports history of chronic alcohol consumption. Associated symptoms include steatorrhea, unintentional weight loss, and postprandial bloating. No current signs of acute flare (fever, vomiting).
Clinical Examination Findings
General: Patient appears cachectic or chronically ill. Abdomen: Epigastric tenderness on deep palpation, no rebound or guarding. Bowel sounds present. Skin: Possible jaundice or signs of malnutrition. Neurological: Alert and oriented, no signs of hepatic encephalopathy.
Treatment Protocol
1. Strict alcohol cessation (referral to addiction specialist if needed). 2. Pancreatic enzyme replacement therapy (PERT) with meals. 3. Pain management: Non-opioid analgesics preferred; consider neuromodulators. 4. Nutritional support: High-protein, low-fat diet; fat-soluble vitamin supplementation (A, D, E, K). 5. Monitor for diabetes mellitus and malabsorption.