Expert Videos

Physicians discuss the approaches to treating acute pancreatitis, including what measures may be needed for more serious attacks like dialysis, the insertion of a breathing tube, or surgery.

Physicians describe cysts, why they form, and how they are treated.

Physicians discuss the likelihood of having multiple attacks of acute pancreatitis and ways to avoid subsequent episodes, including limiting alcohol and high fat food, stopping smoking and the importance of diet and keeping triglycerides in line.

Physicians discuss how acute pancreatitis affects the pancreas and digestive system, including destruction of pancreatic tissue in some cases. Discussion also includes what to expect if sufficient pancreatic tissue is destroyed to affect pancreatic function. EPI is mentioned briefly but is not a focus.

Physicians describe in a fair amount of detail what foods and beverages should be avoided to reduce stress on the pancreas, and which ones are always good to include in the diet.

Physicians discuss the goals of treatment for chronic pancreatitis and how these are achieved. Approaches to pain management and the importance lifestyle changes such as stopping drinking and avoiding high-fat foods are discussed.

Physicians describe the most common nutrition-related diseases that patients with chronic pancreatitis are at risk for, what symptoms to look out for, and what tests can help diagnose nutrition-related disease.

Physicians discuss PERT, why it is needed, when they prescribe it, and how patients should take it.

Physicians discuss outcomes and disease progression in chronic pancreatitis, as well as the nutritional and lifestyle changes that need to be made following diagnosis.

Physicians describe pancreatic stones, why they form, and how they are treated, including the various types of surgeries.

Physicians describe in a fair amount of detail what foods and beverages should be avoided to reduce stress on the pancreas, and which ones are always good to include in the diet.

Physicians discuss the increase in pancreatitis in children, and the diagnosis of the disease in young people.

Physicians discuss the symptoms of pancreatic cancer, including how there are frequently no symptoms early on in the disease.

Physicians describe the most common risk factors for pancreatic cancer (cigarette smoking, industrial chemical exposure, obesity, high fat intake, long-standing diabetes, long-standing chronic pancreatitis) and how the risk can be reduced.

They also discuss screening registries for high-risk individuals.

Physicians discuss when they suspect pancreatic cancer and what tests they use to confirm that diagnosis or to rule out other conditions.

Physicians describe the staging of pancreatic cancer.

Physicians discuss the goals of treatment for pancreatic cancer and how they decide which patients are candidates for curative treatment and which ones are palliative.

Physicians discuss the treatment options for patients who are candidates for curative treatment.

They also talk about the outcomes associated with curative treatment, including survival rates.

Physicians discuss the treatment options for patients who are palliative, including how much treatment can realistically slow the disease and what impact treatment can have on quality of life.

Physicians describe the various surgical resection procedures used for pancreatic cancer.

An emphasis is put on the Whipple procedure.

They also describe what patients should expect going into surgery.

Physicians describe the recovery process following surgical resection procedures for pancreatic cancer, including the most common complications. They talk about chemotherapy and radiation therapy, when these are used and why, and how long after surgery chemotherapy or radiation therapy is started. They also discuss supportive medications following surgery, including length of treatment and possible side-effects.

Physicians discuss the important role of clinical trials in advancing the field of pancreatic cancer and improving outcomes for patients and their families. They describe the goals, benefits and different types of clinical trials, and encourage patients to consider participation.

Physicians discuss new research and medications that are in development for the treatment of pancreatic cancer. They also talk about advances in genetic research and screening opportunities.

Physicians describe what a clinical trial is. Clinical trials are research studies that evaluate new ways to improve treatments and quality of life for people with diseases, like pancreatic cancer. A clinical trial can be part of a number of scenarios and patients can participate in many ways. A clinical trial is how we make progress in cancer research. All the drugs and tools that we have today came about because patients volunteered for clinical trials.

Physicians discuss why clinical trials are important. When it comes to a disease like pancreatic cancer, even though we have made progress we still have a long way to go to improve outcomes for pancreatic cancer patients - and the best way to do that is to test new treatments and new diagnostic tools through clinical trials. By being in a clinical trial patients may benefit from a new treatment, as well as contribute to science and moving the field of medicine forward.

Physicians explain how clinical trials work and the different types of clinical trials and stages – from early stage to late stage. In a clinical trial, there is an individual called the principle investigator, who has primary responsibility for the conduct of the trial, and he or she will work with a team, usually a research nurse and several study coordinators and data managers. The trial is overseen by an institutional review board (IRB) and other committees that govern the scientific merits of the study, and patient welfare and safety. A clinical trial has to be done under rigorous oversight and controls, so it usually means that patients receive treatment in a clinical trial center and not always with their local community oncologist.

Physicians discuss the series of steps (called phases) of clinical trials. Each phase is designed to answer important questions that lead to the next phase. If a patient is thinking about a clinical trial, it’s important to understand which phase the trial is in and what the unique protocol (or plan) is for the study and the eligibility criteria.

Physicians discuss who can participate in a clinical trial. Whether a patient can be enrolled in a clinical trial depends on what’s referred to as “eligibility criteria”. Eligibility criteria differ from one clinical trial to the next and there is a great deal of variation. The highest priority for a clinical trial is to minimize the potential for serious risk and harm. It is a lot of work to have a patient enroll in a clinical trial and it requires careful explanation and discussion on the pros and cons to make sure it is the right fit for that person and that they are truly comfortable with the decision to participate.

Physicians explain the advantages of participating in a clinical trial. By participating in a clinical trial, patients can often expect a higher standard of care, and there is the hope that the clinical trial will benefit the individual patient. We need clinical trials to advance new medical discoveries and to make progress against cancer, so there is also an altruistic aspect to participating in a clinical trial in terms of helping others and advancing medical science.

Physicians discuss the risks and benefits of volunteering for a clinical trial. In terms of benefits of the clinical trial, basic standard of care is usually covered by a patient’s insurance (for example, physician visits and routine blood tests will be covered by insurance) but patients should check to be sure. Also, a research biopsy (taking a piece of the tissue to look at the genetic makeup of the tumor) would typically be covered, and the experimental drug that’s being studied is provided free of cost as part of the trial. An important part of the risks for patients are side effects. Patients need to have a detailed understanding of what the side effects are, and this is part of the consent process which they need to discuss with the researchers. Participating in a clinical trial is not for the faint of heart. It has to be something that patients are really committed to participating in because it will be a bit more intensive than just regular treatments. Of course there is the potential for higher reward. Patients need to understand both the benefits and risks very clearly before they agree to volunteer.

Physicians explain what “informed consent” is in a clinical trial. Informed consent is the process of giving clinical trial participants all of the facts about a trial. Informed consent is greatly important because patients cannot participate in a study without their clear understanding of everything involved. Informed consent means that the patient is making an informed decision on their own, and understands all the risks and benefits for participating in a study. There is a verbal conversation that goes along with this and also a written document. The informed consent document is vetted by an institutional review board (IRB) to make sure it’s not missing anything. Both the physician and the patient will sign the consent form, and then the next step is screening for eligibility and, if the patient qualifies, moving forward with the clinical trial.

Physicians describe the safeguards that are put in place to protect patients in clinical trials. At the beginning, the initial idea for the study undergoes a series of reviews to make sure the study idea is appropriate, that patients will be safe, that the right drugs are being used, and the right end points are going to be answered. A big part of the safeguard process is institutional review board (IRB) oversight. An IRB is a committee that reviews the trial to ensure the science and safety aspects for patient care. Furthermore, the principal investigator has an ethical and professional obligation to both the patient and to the study. In addition, on a national level, there are federal safeguards in place that oversee clinical trials. For example, periodically, audits can be done at institutions of clinical trials to make sure there isn't an important safety signal being missed to make sure that the data is reported accurately and in a timely fashion.

Physicians discuss what happens if a patient changes their mind and wants to leave a clinical trial. A patient has every right to choose to stop participating in a clinical trial at whatever time point they want, even if they don't meet formal criteria for having to be taken off the trial. A patient will be removed from a study if the treatment is not working, if their cancer is continuing to grow, if researchers observe an unacceptable level of potentially serious side effects that may be life-threatening, or if the clinical trial is affecting their quality of life too much. There are also occasions where a patient finds that a clinical trial is just too time-intensive. It’s always important for a patient to talk with the researchers about their reasons for leaving the trial and to make sure that everything is done in the safest manner possible.

Physicians discuss whether patients will be able to pick what medications they will be receiving in a clinical trial. Every clinical trial is different, and sometimes this is possible and sometimes it is not. Sometimes one group of patients will want to choose one option and another group will want the opposite choice. Sometimes a “randomized” trial will be in place, where neither the patient nor the physician can choose which medication the patient will receive. The process of randomization is typically coordinated by computer allocation so that there is no bias in the study design. Randomization can make the results more accurate and more reliable.

Physicians discuss what a “placebo” is in a clinical trial, and if is it always used. Placebos can have some real impacts on a clinical trial. Researchers know that there is an effect from the trial, but they need to isolate that effect to make sure it is really the medicine or device that is causing that effect. In some clinical trials, doctors want to learn if adding a new drug to the standard therapy makes it work better. In these studies, some patients get the standard drug(s) and the new one being tested, while other patients get the standard drug(s) and a placebo. But none of the patients would get only a placebo. The placebo may look like medicine but it has no active ingredient in it. This clinical trial context is typically “blinded”, meaning neither the doctors nor the patients know which group they are in. This ensures there are no doctor or patient biases that impact the outcomes of the clinical trial.

Physicians discuss how patients can find out the results of a clinical trial that they participated in, how results for the larger group of patients are announced, and that individual patient information is always kept confidential. Clinical trial results can be made available to the general public and patients in a number of ways, such as at big scientific meetings, or in journal publications. The goal is to let as many people know as possible and to enhance knowledge sharing amongst the oncology research community to stimulate further ideas and clinical trials. Announcing results often happens when clinical trials are completed and an update will be put on the clinicaltrials.gov website. Occasionally a study will reach an end point and researchers may have to close the study early. As for patient privacy, patients will sign a disclosure that acknowledges that the study team looking after them will have access to their information, however individual information is never shared outside the trial without patient consent. Often the institutional review board (IRB) will have oversight, as well as the company or agency that's funding the trial. The Federal Drug Authority (FDA) can also have access to the information, as well as certain collaborating sites if they are involved in the clinical trial. All of this information should be provided up front to patients and is part of the informed consent process. There are many safety measures in place to protect confidential (also called “Privileged”) information as much as possible.

Physicians explain what randomization, standard of care arm and experimental arm mean in clinical trial study design. Randomization is where participants are assigned by chance to separate groups that compare different treatments, and neither the participant, nor the doctor, nor the medical team can choose which group the participant is assigned to. Typically this is assigned by computer allocation. They also explain that to help support the development of new drugs there needs to be a reference, and that reference is called a standard approach or ‘standard of care.’ Participants may be assigned to the standard of care arm of a study where they receive the standard of care treatment plus placebo, or to the experimental arm where they receive the standard of care plus the new treatment of interest. If a study design is ‘blinded’ it means that one or more parties involved in the trial (such as the participant, or researchers, or sometimes both) do not know which study arm the participant is assigned to.

In this video, physicians explain that endoscopy is a medical procedure that uses an instrument called an endoscope to examine an area of the body, such as the gastrointestinal (GI) tract. They describe the different types of endoscopic procedures that may be used, depending on what is being examined: upper endoscopy (esophagogastroduodenoscopy, or EGD), push enteroscopy, deep endoscopy, and also advanced endoscopic procedures such as Endoscopic ultrasound (EUS) and Endoscopic Retrograde Cholangiopancreatography (ERCP).

Expert physicians discuss Endoscopic Retrograde Cholangiopancreatography (ERCP), which is an upper gastrointestinal (GI) endoscopic procedure used to treat problems of the pancreatic or bile duct. The physicians emphasize that ERCP is used for therapeutic purposes, such as removing stones, placing stents, bypassing obstructions, and more. ERCP helps your doctor make critical decisions concerning your health.

Physicians discuss how ERCP is used as a therapeutic procedure when patient complaints or laboratory findings indicate problems in the bile and pancreatic duct. It is commonly used to bypass obstructions or remove stones, but is also used to remove or treat tumors, infections, inflammation, scarring, fluid or tissue debris. ERCP is generally performed as an outpatient procedure, but can also be performed when the patient is in the hospital for an emergency problem, for example in cases of cholangitis or gallstone pancreatitits.

Pancreatic disease specialists discuss how patients should best prepare for an ERCP procedure and what to expect, including no eating or drinking before ERCP, a thorough understanding of the patient’s medical history, and restriction of certain medications. This will be determined by your doctor. They emphasize the importance of communication between the patient, specialist and primary care provider as part of the preparation plan, so that everybody involved has complete understanding of what is expected going into the procedure.

Physicians discuss the specific details and type of follow-up care that is required after an ERCP procedure, in both the inpatient and outpatient setting. They discuss potential problems to look out for after and ERCP, and the importance of follow-up communication with your doctor.

Physicians describe how the ERCP procedure is performed and the various steps involved, including the scope, camera, x-ray as well as the devices and tools used to examine and treat the pancreatic or bile duct problem. They emphasize that ERCP is an advanced endoscopic procedure that should be performed by well-trained and experienced physicians. They encourage patients to ask their doctor about how much experience they have had performing ERCP.

Pancreatic disease specialists talk about how ERCP is more invasive than routine endoscopic procedures, and that ERCP carries risks of complications, depending on individual patient factors. They discuss risks such as inflammation or pancreatitis, bleeding, infection, perforation. They also describe the techniques they use to minimize these risks.

Physicians discuss the benefits of ERCP and what patients can expect depending on individual patient factors. ERCP can either completely solve a patient's pancreatic problem and alleviate symptoms (such as pain, obstructions, stones and more), or ERCP can indicate the need for further therapeutic interventions. Importantly, ERCP can reduce the risk of other and more serious complications down the line.

Expert physicians describe Endoscopic Ultrasound-Guided Fine-Needle Aspiration (EUS-FNA), which is a specialized gastrointestinal endoscopic procedure that uses ultrasound imaging of the digestive tract (including the pancreas and surrounding abdominal structures) and biopsy via fine-needle aspiration to allow your doctor to sample areas of interest for analysis. Patients may be referred for an EUS for several reasons that include: evaluation of pancreatic lesions or tumors; further evaluation of cystic lesions of the pancreas; and in patients with suspected, or established, chronic pancreatitis.

Physicians discuss the indications for EUS-FNA, namely investigating abnormal findings from prior exams and tests, evaluating masses, tumors, lesions and abnormalities of the gastrointestinal (GI) tract, staging of cancers, and more. The findings from the EUS-FNA test are helpful to surgeons and oncologists, to assess and determine what the next step of treatment will be for the patient.

Pancreatic disease specialists discuss how patients should prepare for an EUS-FNA procedure and what to expect. Patients should not eat or drink for 8 hours before the procedure. Certain medications may be restricted so it is important to tell your doctor what medications you are currently taking. Before you are discharged from the hospital, you must make arrangements with a family member or a close friend to drive you home. The experts emphasize the importance of communication between the patient and the surgeon, so that the patient has a clear understanding of what is to be expected before, during and after the procedure.

In this video, pancreatic disease specialists discuss the follow-up care that is required following an EUS-FNA procedure. Before being discharged home, patients will have an opportunity to meet with the physician to discuss the results of the procedure, and receive further instructions regarding medications and additional follow-up. A definitive diagnosis can take up to a week, or can be sooner depending on the circumstances. The experts also talk about some of the potential problems to look out for after an EUS-FNA, as well as the importance of calling your doctor if any troublesome complications arise.

In this video, pancreatic disease specialists discuss the benefits and rare risks associated with EUS-FNA. The main benefit of EUS-FNA is that it is a relatively non-invasive procedure that provides a large amount of information and a specific diagnosis that has high sensitivity and high specificity. Patients and physicians should discuss the benefits and risks prior to the EUS-FNA procedure and determine what will benefit the patient the most.

Physicians discuss EPI, including causes, risk factors and long-term consequences like nutrition-related diseases. They also discuss inherited conditions that are linked to EPI.

Physicians discuss how they diagnose EPI, including lifestyle factors and symptoms that lead them to suspect EPI, and the follow-up tests that confirm the diagnosis.

Physicians discuss the approaches to treating EPI including pancreatic enzyme replacement therapy (PERT), vitamin and mineral supplementation, and dietary interventions. They also discuss when they decide to implement PERT.

Chris Forsmark, MD, Chief of Gastroenterology at the University of Florida in Gainesville, discusses the condition of ongoing pancreas inflammation, including scarring and loss of cells. He describes the consequences of having a damaged pancreas, including the effects on enzyme production, insulin production, and general health. Dr. Forsmark also explains why it is important to see your doctor regularly if you have chronic pancreatitis.

In this video, the University of Florida's chief gastroenterologist Dr. Chris Forsmark, an expert on digestive conditions including chronic pancreatitis, explains the role of imaging scans such as CT and MRI in learning if someone has chronic pancreatitis and if so, how far advanced the condition is. He also describes the role of tests for pancreas function and tests of general health and nutrition. Andres Gelrud, MD, MMSc, of Baptist Health in South Florida discusses the role of a complete medical history and symptom description with Dr. Forsmark, including the importance of being open with your doctor about digestive symptoms.

Chris Forsmark, MD, professor and chief of gastroenterology at the University of Florida in Gainesville, discusses the many causes of chronic pancreatitis. He discusses the main myth about what causes this condition, the roles of smoking and genetics, and the other medical conditions that can lead to chronic pancreatitis.

How does chronic pancreatitis change over time? Does this disease advance quickly? An expert in digestive system diseases, Chris Forsmark, MD, of the University of Florida, describes what patients and caregivers should know about chronic pancreatitis, including possible ways to slow and prevent more damage to the pancreas. He describes the need for regular care, what to do if you have other health conditions, and the most important habit to quit when you have chronic pancreatitis.

Andres Gelrud, MD, MMSc, of the Miami Cancer Institute at Baptist Health in South Florida, explains the meaning of the term "exocrine pancreas insufficiency" and what this condition can lead to. He discusses some possible signs and how this condition can be treated.

Learn the signs of poor nutrition when you have chronic pancreatitis from expert Andres Gelrud, MD, MMSc, of the Miami Cancer Institute at Baptist Health in South Florida. Do you have vague digestive symptoms, from discomfort and gas to a noisy digestion? Have you noticed changes in your bowel movements or how often you need to use the restroom? What are the other signs that you may not be getting the nutrition your body needs? Learn how chronic pancreatitis can lead to other medical problems you may not expect. Fellow expert Chris Forsmark, MD, talks with Dr. Gelrud about more subtle signs and symptoms of poor nutrition.

Dr. Andres Gelrud of the Miami Cancer Institute explains steatorrhea, a type of change in bowel movements and how you can recognize it at home. With colleague Chris Forsmark, MD, of the University of Florida, Dr. Gelrud explains what having this type of bowel movement means for your nutrition status and general health.

Andres Gelrud, MD, MMSc, an expert on chronic pancreatitis, talks about how essential good nutrition is to any chronic condition, especially to one that involves digestive enzymes. He describes the importance of working directly with a professional nutritionist on your healthcare team. Dr. Gelrud also discusses the role of hydration, diet, and lifestyle changes. Fellow expert Chris Forsmark, MD, adds an important note for people who have diabetes in addition to chronic pancreatitis.

Anna Evans Phillips, MD, MS, University of Pittsburgh expert on chronic pancreatitis and other digestive diseases, talks about the importance of an individual nutrition plan if you have chronic pancreatitis. She discusses which lifestyle habits can worsen chronic pancreatitis, which food choices are more likely to bring on an attack, and why weighing a bit more than recommended may help if you have this condition. Dr. Phillips also describes what other health conditions can develop with chronic pancreatitis and how to avoid them.

Dr. Anna Evans Phillips of the University of Pittsburgh Department of Gastroenterology, Hepatology, and Nutrition talks about the importance of learning about your symptoms, diet, past history with pancreatitis, and general health during a chronic pancreatitis nutrition assessment. She describes talking with patients, testing blood samples, and which scans and other tests can be helpful in checking for additional health conditions and any complications of chronic pancreatitis.

Anna Evans Phillips, MD, MS, pancreatitis expert from the University of Pittsburgh, explains that while talking about bowel movements and stool can be embarrassing for patients, your doctor is very familiar with these topics and needs as much information as possible in order to fully understand your chronic pancreatitis and nutrition and health status.

Dr. Anna Evans Phillips of the University of Pittsburgh discusses what to eat and avoid when you have chronic pancreatitis. She talks about the importance of managing fat intake, how often to eat, and how to balance your diet. Dr. Phillips also addresses which supplements you may need and what your doctor may prescribe. Chris Forsmark, MD, joins her to recommend a cookbook for people with chronic pancreatitis.

Pancreatic enzyme therapy is explained by expert Anna Evans Phillips, MD, of the University of Pittsburgh. Do you have difficulty digesting food due to chronic pancreatitis? Have you been diagnosed with exocrine pancreatic insufficiency? You may need one or all of the main enzymes produced by a healthy pancreas. Dr. Phillips talks about what your doctor may prescribe, how these enzymes work, and when to take them so they are most effective.

Anna Evans Phillips, MD, gastroenterologist and pancreatitis expert, talks about medications that can relieve pain and other symptoms common with chronic pancreatitis. With colleague Andres Gelrud, MD, MMSc, she discusses emotional symptoms and sleep problems that you should let your doctor know about, and how those can also be helped. Finally, Dr. Phillips talks about managing any other conditions so you stay as healthy as possible.

Chris Forsmark, MD, and Anna Evans Phillips, MD, MS, describe the promising state of chronic pancreatitis research with multiple clinical trials available. Dr. Phillips talks about the National Pancreas Foundation's list of trials and Centers of Excellence, as well as ClinicalTrials.gov. Dr. Forsmark describes the investment that has been made in studying pancreatitis and the new treatments that are in development, providing hope for many patients.

Physicians describe the pancreas and the role it plays in the body. They describe the pancreas as the organ responsible for the secretion of enzymes to aid in the digestion of food and for the production of the hormone, insulin, which aids in the absorbing of nutrients from the blood.

Physicians describe what acute pancreatitis is and how it is more prevalent in children than was previously understood. They mention that acute pancreatitis is typically reversible and symptoms usually go away with time.

Physicians discuss how acute pancreatitis in children can stem from numerous factors, including those children who may have a systemic illness, viral infection, or trauma. Other causes they discuss may include being due to medication, a metabolic issue, or even abnormal kidney functioning. Genetic risk factors such as a family history of the disease, as well as environmental factors can also be responsible.

Physicians discuss how a child's first attack of acute pancreatitis can originate from a range of causes, which unlike adult cases is typically due to two major causes. They note that doctors look at all of the possible risk factors when dealing with children, in order to help prevent future episodes of acute pancreatitis.

Physicians discuss how 15-20% of cases of acute pancreatitis in children are due to gallstones, which may indicate the need for the child to have a surgical intervention.

Physicians discuss how the symptoms of acute pancreatitis can be quite non-specific and can make it challenging to diagnose. They discuss how symptoms can range from abdominal pain, vomiting, fever, jaundice, and irritability but how such symptoms will differ depending on the age group of the child.

Physicians discuss how the course of acute pancreatitis in children can be quite variable, ranging from a week or less in some instances, and up to 2 weeks in more rare cases. They mention that if the symptoms are severe, the child may require hospitalization for however long the symptoms last.

Physicians discuss how symptoms of acute pancreatitis may resolve in children, but that up to 1/3 of these children could still experience another attack and families need to be aware of this. They note that symptoms of a subsequent attack may or may not necessarily resemble those from a previous attack.

Physicians discuss the types of complications that may arise in children with acute pancreatitis. These can involve the accumulation of fluid - either around the pancreas or within the left-side of the chest - and the draining of that fluid to prevent the issues that can arise if left untreated. They note that while kidney failure is rare in children, physicians need to monitor for it.

Physicians discuss how acute pancreatitis is diagnosed in patients who meet at least 2 of the 3 following criteria: 1) displaying the typical symptoms of pancreatitis; 2) having elevated blood levels of the enzymes lipase or amylase; and 3) having findings of pancreatitis from ultrasound or CAT scans.

Physicians discuss about "supportive care" as a treatment option for acute pancreatitis in children. As there is no cure for acute pancreatitis, they describe supportive care as providing children with therapies to aid them with getting through their illness. Methods for managing pancreatitis in children (such as IV therapy, pain medication, and fasting for blood work) have changed over time, with families being able to treat mild episodes of acute pancreatitis at home while remaining in close communication with their physicians.

Physicians discuss about how recurring episodes of acute pancreatitis may be prevented by first aiming to isolate the cause and removing it to see if that resolves the issue. They explain how in cases where no cause can be found, different treatment regiments, such as pancreatic enzyme supplementation, antioxident cocktails, or a low-fat diet, may be recommended, although neither of these may be more effective than no medication. Despite this, physicians remain committed to understanding and finding a solution to cases where there is no obvious cause of acute pancreatitis.

Physicians discuss whether families should consider special diets, supplements, vitamins, or medications for their child following recovery from acute pancreatitis in order to prevent future episodes from recurring. They describe that most children will be able to, and should, return to their regular diet, supplements, and medication prior to having had their episode. In rarer and more severe cases however, they recommend a low-fat diet for a week or so. At present, there is no clear evidence of any specific diet, vitamins, or medications that will prevent future episodes of acute pancreatitis.

Physicians discuss how chronic pancreatitis can develop from repeated episodes of pancreatic inflammation, resulting in long term, irreversible damage to the pancreas. They discuss how a child can transition from having acute pancreatitis to chronic pancreatitis, but that the rate of progression can depend on the child's genetic makeup.

Physicians discuss chronic pancreatitis in children which is relatively rare and stems from causes that are either obstructive or genetic in nature. They describe how obstructive causes result from abnormalities in the pancreatic tubes or ducts, but that these are generally treatable. Genetic risk factors also account for children developing chronic pancreatitis, although having risk factors does not necessarily mean that a child will develop the pancreatitis. Other factors such as environment may be a contributing factor as well.

Physicians describe chronic pancreatitis as a disease that is complex to diagnose. Diagnosis frequently relies on the assistance of imaging tools that include CT and MRI scans, endoscopic ultrasound, and ERCP. These tools used to visualize the pancreas and to determine if specific criteria for making a diagnosis are met. They note that it is important to realize that chronic pancreatitis will appear differently from one patient to the next.

Physicians discuss the use of MRCP versus ERCP as an imaging tool for diagnosing chronic pancreatitis. They explain how MRCP has a great capacity for the initial imaging of the pancreatic ducts, while ERCP serves as a viable option when surgical intervention is necessary.

Physicians discuss that chronic pancreatitis is a life long illness that unfortunately can be quite disruptive on quality of life. They also discuss recent and ongoing efforts to develop support groups that aim to connect families caring for children with chronic pancreatitis.

Physicians describe the medical treatment and endoscopic options available to patients for treating chronic pancreatitis. Since multiple needs and symptoms can arise from chronic pancreatitis, they explain that the illness should be addressed using a multidisciplinary approach in order to achieve the best patient health outcomes. Should those options fail to provide relief, surgery is also mentioned as an option.

Physicians describe how nutrition is an important consideration over the long term in patients with chronic pancreatitis. Given the vital role of the pancreas in the digestion of food, they discuss what tests and procedures may be used to measure the function of the pancreas and if any changes to diet, nutrition, or vitamin intake should be recommended based on the findings.

Physicians describe the long-term health outlook for children and teens who have chronic pancreatitis. They explain that because the disease is quite variable, some patients will manage better than others, although the majority will develop some form of chronic pain over time. Another concern discussed is the possibility for some children to develop diabetes - the onset of which is also variable. Finally, the risk of developing pancreatic cancer is of greater concern for teens due to increased opportunities for smoking and drinking.

Physicians discuss whether surgery, as well as a number or other types of intervention, can benefit children as treatment options in acute pancreatitis. They explain that in severe cases involving certain types of complications, surgery, interventional radiology, as well as more novel endoscopic approaches can be viable options for consideration. Families may be in contact with a team of specialized care providers ranging from critical care physicians, GI physicians, surgeons, and interventional radiologists, in order to determine the best individualized care for their loved ones.

Physicians explain how patients with chronic pancreatitis can have a range of surgery options made available to them if medical and endoscopic approaches have been exhausted, chronic pain has become debilitating, or if the patient needs to rely on opioids over the long term. They discuss how surgical operations can range from more conventional procedures - such as Puestow or Whipple procedures - to more extensive operations like a total pancreatectomy with islet autotransplantation (TPIAT).

Physicians describe what is involved in having a total pancreatectomy with islet autotransplantation (TPIAT) and what the potential health outcomes are for patients post-surgery. They explain how TPIAT is the most complex pancreatic operation offered, entailing the removal of the pancreas, and the isolation and injection of specialized islet cells that produce insulin. In over 90% of children that undergo a TPIAT, the main outcome is relief from debilitating pain, freedom from opioid reliance, and overall improvement in quality of life.

Physicians describe what Familial Chylomicronemia Syndrome (FCS) is, and how it is different to other causes of high triglyceride-related pancreatitis. FCS is a genetic condition that causes a buildup of triglycerides in the blood that can increase the risk of abdominal pain and pancreatitis. They also briefly discuss the familial and genetic aspects of FCS, and how it is diagnosed.

Physicians explain that chylomicrons are balls of fat that store triglycerides. Normally, an enzyme called lipoprotein lipase (LPL) helps the body break chylomicrons apart to release the triglycerides. But when you have FCS, the LPL is missing or broken, resulting in chylomicrons increasing to very high levels in the blood, which can trigger various symptoms and diseases such as pancreatitis.

Physicians discuss the underlying cause of Familial Chylomicronemia Syndrome (FCS). When you have FCS, the enzyme lipoprotein lipase (LPL) doesn’t work correctly and chylomicrons build up to very high levels in the blood, which can lead to diseases such as pancreatitis.

Physicians discuss the signs and symptoms that someone may have with Familial Chylomicronemia Syndrome (FCS). Frequent and severe abdominal pain is the most common symptom of FCS, and often it’s caused by pancreatitis. They also discuss other symptoms including: brain fog, xanthomas, milky appearance of blood vessels in the eye, and swelling of the liver and spleen.

Physicians describe the factors that may trigger pancreatitis in patients with Familial Chylomicronemia Syndrome (FCS). People with FCS are at high risk for pancreatitis, therefore the main goal of treatment is to lower triglyceride levels as much as possible to prevent the risk of getting pancreatitis.

Physicians describe the genetics of Familial Chylomicronemia Syndrome (FCS) and explain that it is a rare autosomal recessive disorder. If you have FCS, your family members or relatives may also have it, or they may carry one copy of the abnormal gene. People who have one abnormal gene are called carriers. They don’t have FCS, but if two carriers have a child together, there’s a one in four chance that the child will have FCS.

Physicians describe the many challenges that patients with Familial Chylomicronemia Syndrome (FCS) face, including: diagnosis challenges, high symptom burden, treatment challenges, difficulty in maintaining a very-low-fat diet, and the enormous social burden which affects patients as well as their family members.

Physicians explain why patients with Familial Chylomicronemia Syndrome (FCS) should follow an extremely low fat diet, and what it consists of. At this time, the only effective treatment for FCS is to follow a very low fat diet that includes less than 20 grams of fat per day. You can achieve this by eating low-fat foods like vegetables, fruit, egg whites, low-fat dairy products, fish, and lean poultry. Nutrition plays a key role in managing FCS, therefore working with a registered dietician and a doctor who is an expert in lipid disorders is critically important. The National Pancreas Foundation and the FCS Foundation can help if you need guidance and support.

Physicians describe how alcohol and tobacco sensitize the pancreas to getting inflamed, which is pancreatitis. If you have Familial Chylomicronemia Syndrome (FCS) avoidance of alcohol is important, as it may cause your triglyceride levels to increase, which can trigger an episode of pancreatitis.

Physicians discuss the increased risk of pancreatitis that women with Familial Chylomicronemia Syndrome (FCS) face if they become pregnant. During normal pregnancy a woman’s triglyceride levels increase. When a pregnant woman has FCS, the triglyceride levels get even higher and may be enough to trigger pancreatitis, especially in the 3rd trimester.

Physicians explain that at present, there are no drug treatment options for FCS that have been approved by the FDA. However, new drugs for FCS are being tested in clinical trials. If you would like to find out more about clinical trials for new FCS treatments, talk with your doctor or get in touch with the National Pancreas Foundation or the FCS Foundation.

Physicians provide an overview of reliable resources and networks to get in touch with for information and support for FCS. Contact the National Pancreas Foundation and the FCS Foundation for support and education for patients, caregivers, and health care professionals.

Physicians discuss how they diagnose Familial Chylomicronemia Syndrome (FCS), including the use of genetic tests, blood tests, assessing signs and symptoms, and measuring a patient’s response to certain medications that lower triglyceride levels. Patients with FCS will have little or no response to these medications because their enzyme lipoprotein lipase (LPL) is missing or doesn’t work correctly.

Physicians explain that at present, there are no drug treatment options for FCS that have been approved by the FDA. However, new drugs for FCS are being tested in clinical trials. If you would like to find out more about clinical trials for new FCS treatments, talk with your doctor or get in touch with the National Pancreas Foundation or the FCS Foundation.