Idiopathic recurrent acute pancreatitis: current and future approaches to management.

Pramod Kumar Garg, Pranjal Singh, Soumya Jagannath Mahapatra

Journal: Current opinion in gastroenterology 2025;41(5):361-368

PMID: 40682397

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Abstract

PURPOSE OF REVIEW

Idiopathic recurrent acute pancreatitis (IRAP) is a clinically relevant condition with a high likelihood of progression to chronic pancreatitis (CP) in 20-50% of patients. This review outlines the importance of early diagnosis of IRAP and potential upcoming therapies to halt disease progression. It highlights a potential therapeutic window in the natural history of IRAP.

RECENT FINDINGS

Despite advancements in diagnostic modalities, identifying a definitive aetiology remains challenging in a significant proportion of cases. Current approaches emphasize structured, stepwise evaluation including metabolic, genetic, and structural factors. Emerging therapies aim to target inflammation, trypsin activation, and pancreatic fibrosis.

SUMMARY

While diagnostic tools have improved, therapeutic options remain limited in IRAP. Early identification of modifiable risk factors, use of advanced imaging, and application of evolving treatment strategies may offer an opportunity to prevent the transition from IRAP to CP. Future research must focus on validating disease-modifying treatments and optimizing individualized management strategies.

Address: Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.

DOI: 10.1097/MOG.0000000000001122