Treatment of chronic pancreatitis in a super-aging society

Abstract

As we enter the era of the super-aging society, the demand for medical care for the elderly in the treatment of chronic pancreatitis is steadily increasing. The latest nationwide survey in Japan revealed that 17.6% of patients with chronic pancreatitis are aged 75 years or older, and that the etiology of chronic pancreatitis in the elderly is less frequently alcoholic and more frequently idiopathic. Chronic pancreatitis in the elderly is often painless, and pancreatic exocrine dysfunction should be noted. In terms of treatment, from the viewpoint of complications such as frailty, sarcopenia, and osteoporosis, it is important to provide adequate pancreatic enzyme replacement therapy and dietary guidance without fat restriction for patients in the uncompensated phase. The management of malignant tumors including pancreatic cancer is often necessary in elderly patients with chronic pancreatitis. In addition to these characteristics of chronic pancreatitis in the elderly, careful and individualized medical care is required, taking into account physiological changes associated with aging, multiple comorbidities, adverse events associated with drug therapy, and social factors that are specific to the elderly.