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q

February 12 2008 at 3:34 AM
Anonymous  (no login)


A 52-year-old man, who recently transferred to the city, comes to the office for a first visit complaining of weight loss and frequent malodorous stools. He admits to abusing alcohol and reports that he has developed chronic pancreatitis from his alcoholism. For the past year, he has given up alcohol completely and has transferred his job to your city. He reports that he has lost 20 pounds over the past 3 months. In addition, he reports frequent, greasy, malodorous stools. He denies any recent alcohol consumption and any abdominal pain. Laboratory studies and a CT scan of the abdomen confirm the diagnosis of chronic pancreatitis. A 72-hour fecal fat collection confirms steatorrhea. The most appropriate treatment for this patient is

A. endoscopic placement of pancreatic duct stent


B. an enteric-coated pancreatic enzyme replacement tablet with meals and calcium-containing antacids


C. a low-fat diet


D. a non-enteric coated pancreatic enzyme replacement with H2 blockers


E. octreotide

 

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