Pharmacological And Non-Pharmacological Management Of Acute Pancreatitis: A Comparative Review
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Abstract
Acute pancreatitis is a complex inflammatory condition of the pancreas with a wide spectrum of clinical severity, ranging from mild, self-limiting episodes to severe, life-threatening forms associated with organ failure and high mortality rates. The management of acute pancreatitis is challenging, with a growing need for effective treatment strategies due to increasing incidence and hospital admission rates globally. This review explores and compares pharmacological and non-pharmacological approaches to managing acute pancreatitis.
Non-pharmacological management primarily focuses on supportive care, including fluid resuscitation, oxygen therapy, and nutritional strategies aimed at pancreatic rest. Early and adequate fluid resuscitation within the first 24 hours is critical to improving outcomes. Nutritional interventions, such as early enteral feeding and, in select cases, total parenteral nutrition (TPN), are emphasized to maintain metabolic stability and minimize complications.
Pharmacological management involves addressing the disease’s symptoms and complications. Pain relief, often with NSAIDs or opioids, is a cornerstone of care. Antibiotics are reserved for confirmed cases of infected necrosis, while secretory inhibitors such as somatostatin and trypsin inhibitors are employed in moderate to severe cases. Novel pharmacological interventions, including the use of Neostigmine and other repurposed drugs, are being explored in clinical trials to target specific pathophysiological mechanisms.
This review underscores the importance of a multidisciplinary, patient-centered approach to treatment. While pharmacological strategies are essential for managing complications, non-pharmacological interventions remain foundational in acute care. Ongoing research is critical to refine existing therapies and develop new modalities to improve outcomes and prevent recurrence, ultimately bridging the gap between supportive care and disease-specific treatment.