Evidence map›Paper›PMID 40944111›Full record

ReviewNutrients2025

Nutritional Management in Chronic Pancreatitis: From Exocrine Pancreatic Insufficiency to Precision Therapy.

Angelo Bruni, Luigi Colecchia, Giuseppe Dell'Anna, Davide Scalvini, Francesco Vito Mandarino, Andrea Lisotti, Lorenzo Fuccio, Paolo Cecinato, Giovanni Marasco, Gianfranco Donatelli and 2 more

Abstract readReview
In one paragraph

Review in Nutrients, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Autoimmune Pancreatitis Re-Classification with Novel Type AIP-4.International journal of molecular sciences · 2026
    Review
  6. Article
  7. Review
  8. Review
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Angelo BruniGastroenterology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.ORCID 0009-0002-0895-1225
Luigi ColecchiaGastroenterology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.ORCID 0000-0002-0217-8780
Giuseppe Dell'AnnaGastroenterology and Gastrointestinal Endoscopy Unit, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy.ORCID 0000-0002-9395-5468
Davide ScalviniPavia-Gastroenterology and Digestive Endoscopy Unit, Department of Internal Medicine and Therapeutics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy.ORCID 0009-0002-7051-5432
Francesco Vito MandarinoGastroenterology and Gastrointestinal Endoscopy Unit, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy.ORCID 0000-0002-9931-7221
Andrea LisottiGastroenterology Unit, Hospital of Imola, University of Bologna, 40026 Bologna, Italy.ORCID 0000-0002-7724-7402
Lorenzo FuccioGastroenterology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
Paolo CecinatoGastroenterology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.ORCID 0000-0002-1870-5952
Giovanni MarascoDepartment of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy.ORCID 0000-0001-7167-8773
Gianfranco DonatelliUnité d'Endoscopie Interventionnelle, Hôpital Privé des Peupliers, 75013 Paris, France.
Giovanni BarbaraGastroenterology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
Leonardo Henry EusebiGastroenterology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.ORCID 0000-0003-3323-7744

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chronic pancreatitis (CP) precipitates complex malnutrition through synergistic mechanisms: exocrine pancreatic insufficiency-driven maldigestion, duodenal or pancreatobiliary strictures limiting nutrient flow, cholestasis impairing micelle formation, alcohol-related anorexia, pain-induced hypophagia, proteolytic catabolism from type 3c diabetes, and a chronic inflammatory milieu that accelerates sarcopenia and bone demineralisation. Consequent calorie-protein depletion, micronutrient and fat-soluble vitamin deficits, and metabolic derangements markedly amplify morbidity. Pancreatic enzyme replacement therapy (PERT) with targeted micronutrient repletion is foundational; high-protein regimens co-administered with PERT curb muscle loss, and medium-chain triglycerides (MCTs) can augment caloric delivery by bypassing lipase dependence, although their benefit over personalised dietetic counselling is marginal. Optimal dietary fat thresholds and timing of escalation from oral to enteral or parenteral feeding remain unresolved. Comprehensive care also demands alcohol abstinence, effective analgesia and stringent glycaemic control. Serial monitoring-biochemical indices, densitometry, dual-energy X-ray absorptiometry and imaging-based body-composition metrics-permits early detection of high-risk patients and precision tailoring of interventions. Intensified multidisciplinary programmes already improve prognostic endpoints and are unveiling biomarkers of nutritional resilience. A structured, evidence-based strategy integrating PERT, macronutrient engineering, micronutrient repletion and metabolic surveillance is essential to mitigate nutrition-related morbidity, enhance long-term outcomes and optimise quality of life in CP.

Indexed as

Exocrine Pancreatic InsufficiencyMalnutritionNutritional SupportNutrition TherapyPancreatitis, ChronicPrecision MedicineEnzyme Replacement TherapyHumansMicronutrientsNutritional StatusMicronutrientschronic pancreatitisexocrine pancreatic insufficiencypancreatic enzyme replacement therapy

Identifiers

PMID40944111
PMCPMC12430654

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.