Mária Voleková
Chronic pancreatitis includes a destruction the pancreatic tissue and stimulation of pancreatic fibrogenesis and thus it can lead to exocrine and endocrine pancreatic insufficiency resulting in malnutrition. Very serious form of chronic pancreatitis is hereditary pancreatitis caused by CFTR (cystic fibrosis transmembrane conductance regulator) gene mutation. The main symptoms of chronic pancreatitis are impaired digestion of fats with steatorrhoea and pancreatic pain. Abstaining from alcohol and pancreatic enzyme substitution are the key elements of management of chronic pancreatitis. Preferred form of pancreatic enzyme substitution is multienzyme formulas stored in acidoresistant micropelets covered by gelatine. The dose of enzymes should reflect the total fat intake. If the treatment is ineffective, we recommend to use MCT oil or oligopeptide diets which do not require digestion, instead of regular plant and animal fats. After natural or enteral nutrition fail to improve malnutrition, home parenteral nutrition is indicated.