Follow-up investigations/monitoring if chronic pancreatitis

Follow-up investigation

Follow-up of pancreatic exocrine function

• offer people with chronic pancreatitis monitoring by clinical and biochemical assessment, to be agreed with the specialist centre, for pancreatic exocrine insufficiency and malnutrition at least every 12 months (every 6 months in under 16s). Adjust the treatment of vitamin and mineral deficiencies accordingly
• offer adults with chronic pancreatitis a bone density assessment every 2 years.

Follow-up to identify pancreatic cancer

• people with chronic pancreatitis have an increased risk of developing pancreatic cancer
  • lifetime risk is highest, around 40%, in those with hereditary pancreatitis.
• annual monitoring for pancreatic cancer should be considered in people with hereditary pancreatitis.

Follow-up to identify diabetes

• people with chronic pancreatitis have a greatly increased risk of developing diabetes, with a lifetime risk as high as 80%.
  • risk increases with duration of pancreatitis and presence of calcific pancreatitis
• people with chronic pancreatitis should be offered monitoring of HbA1c for diabetes at least every 6 months

Reference:

1. NICE. Pancreatitis. NICE guideline NG104. Published September 2018, last updated December 2020