Bejjani Joseph, Culp Stacey, Nikahd Melica, Phillips Anna Evans, Singh Vikesh, Roberts Kristen M, Abu-El-Haija Maisam, Krishna Somashekar G, Ramsey Mitchell L, Lahooti Ali, Lee Peter J, Hart Phil A, Papachristou Georgios I
Division of Gastroenterology, Hepatology, and Nutrition, Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA.
Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Clin Transl Gastroenterol. 2025 Feb 1;16(2):e00799. doi: 10.14309/ctg.0000000000000799.
Gastrointestinal (GI) symptoms and weight loss develop during and after acute pancreatitis (AP), but remain understudied. In this prospective, multicenter study, we aim to assess GI symptom burden and weight loss and their correlation with exocrine function up to 12 months post-AP.
GI symptom burden, anthropometrics, and exocrine pancreatic function were systematically measured in adults (≥18 years) with AP at predefined intervals: hospitalization (enrollment), 3 months, and 12 months post-AP. Symptoms were evaluated using a 15-item tracker, including abdominal symptoms, stool characteristics, and activities of daily living, higher scores indicating greater symptom burden (range 0-45). Exocrine function was assessed with fecal elastase-1 (FE-1) levels.
GI symptoms were collected in 97 participants with 12-month follow-up. The median (interquartile range) GI-symptom score was 7 (3-12) with 55 participants (57%) experiencing at least one symptom frequently (often or almost always). In multivariable linear regression, younger age, lower Charlson Comorbidity Index, smoking, recurrent AP, and alcoholic or idiopathic etiologies were associated with significantly higher GI-symptom burden at 12 months. A significant negative correlation was found between GI symptoms and FE-1 levels during hospitalization ( ρ = -0.288; P = 0.015) and at 12 months ( ρ = -0.219; P = 0.046). Eighteen participants (18.6%) lost ≥10% body weight between hospitalization and 12 months, and had significantly lower median FE-1 levels at 12 months compared with the group without weight loss (166 vs 332 µg/g, P = 0.016).
This is the first study to prospectively assess GI-symptom burden and exocrine function post-AP. Lower exocrine pancreatic function at 12 months was associated with increased symptom burden and weight loss. These findings support further investigations to define and improve patient-reported outcomes post-AP. This study is registered with ClinicalTrials.gov , NCT03063398.
胃肠道（GI）症状和体重减轻在急性胰腺炎（AP）期间及之后出现，但仍未得到充分研究。在这项前瞻性多中心研究中，我们旨在评估AP后长达12个月的胃肠道症状负担、体重减轻情况及其与外分泌功能的相关性。
对成年（≥18岁）AP患者在预定时间点系统测量胃肠道症状负担、人体测量指标和胰腺外分泌功能：住院时（入组）、AP后3个月和12个月。使用15项追踪器评估症状，包括腹部症状、粪便特征和日常生活活动，分数越高表明症状负担越重（范围0 - 45）。通过粪便弹性蛋白酶-1（FE-1）水平评估外分泌功能。
97名参与者完成了12个月的随访并收集了胃肠道症状数据。胃肠道症状评分中位数（四分位间距）为7（3 - 12），55名参与者（57%）经常（经常或几乎总是）出现至少一种症状。在多变量线性回归中，年龄较小、Charlson合并症指数较低、吸烟、复发性AP以及酒精性或特发性病因与12个月时显著更高的胃肠道症状负担相关。住院期间（ρ = -0.288；P = 0.015）和12个月时（ρ = -0.219；P = 0.046），胃肠道症状与FE-1水平之间存在显著负相关。18名参与者（18.6%）在住院至12个月期间体重减轻≥10%，与未体重减轻组相比，12个月时FE-1水平中位数显著更低（166 vs 332 µg/g，P = 0.016）。
这是第一项前瞻性评估AP后胃肠道症状负担和外分泌功能的研究。12个月时较低的胰腺外分泌功能与症状负担增加和体重减轻相关。这些发现支持进一步研究以明确和改善AP后患者报告的结局。本研究已在ClinicalTrials.gov注册，注册号为NCT03063398。
