Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for follow-up of chronic pancreatitis, currently in a painless phase. Primary complaints include signs of exocrine pancreatic insufficiency (EPI), specifically steatorrhea, bloating, and unintentional weight loss. Denies abdominal pain, nausea, or vomiting. Reports adherence to current pancreatic enzyme replacement therapy (PERT) but notes persistent loose, malodorous stools. No history of recent alcohol intake or tobacco use.
Clinical Examination Findings
General: Patient appears well-nourished but shows signs of recent weight loss. Vitals stable. Abdomen: Soft, non-distended, non-tender to palpation. No guarding or rebound. Bowel sounds present and normal. No organomegaly or palpable masses. Skin: No jaundice or pallor. Extremities: No peripheral edema.
Treatment Protocol
1. Pancreatic Enzyme Replacement Therapy (PERT): Continue [Dose] units with meals and [Dose] units with snacks. 2. Nutritional Support: High-calorie, high-protein diet; monitor for fat-soluble vitamin deficiencies (A, D, E, K). 3. Lifestyle: Strict abstinence from alcohol and tobacco. 4. Monitoring: Repeat fecal elastase-1 and nutritional labs (albumin, prealbumin, vitamin levels) in 3 months.