This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The treatment of abdominal pain in chronic pancreatitis is unsatisfactory. Medical therapy includes abstinence from alcohol, analgesics, and pancreatic enzymes. Nonenteric-coated enzymes are primarily used for pain since they deliver serine proteases to the duodenum and can reduce excess stimulation by CCK in these patients. Randomized trials of these enzymes demonstrate they reduce pain in some patients. Failure of medical therapy is not uncommon. Some patients are candidates for endoscopic or surgical therapy; these can only be applied in a subgroup of patients with substantial abnormalities of the pancreatic duct. Many patients continue to experience pain despite medical and other therapies. Better therapies are needed. The primary objective of this pilot trial is to evaluate the effect of Sandostatin LAR on pain in subjects with painful chronic pancreatitis and to compare it to a bioequivalent dose of Sandostatin . The primary endpoint is to determine the reduction in pain as determined by VAS (visual analog scale). Secondary endpoints will be changes in quality of life, nutritional status, percent reduction in pain medication, and effect on subject reported health outcomes. Approximately 25 subjects already taking Sandostatin will be enrolled and serve as their own control. Eligible subjects will be treated with Sandostatin LAR for a total of 6 months. Subjects will keep a daily diary of pain medication usage and will record their worst pain for the day on a VAS. Quality of life, nutritional status and subject reported health outcomes will be assessed on a routine basis.
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