Bile Salt Malabsorption in Pancreatic Insufficiency Secondary to Alcoholic Pancreatitis

Dutta, Sudhir K.; Anand, Kuldip Parkash; Gadacz, Thomas R.

doi:10.1016/s0016-5085(86)80023-3

Cited by 40 publications

(10 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Antispasmodic agents such as hyoscyamine and dicyclomine are often prescribed but have not been established to be beneficial and may lose any possible benefit over time 7. Pancrealipase (PEZ) has been shown to reduce bile acid malabsorption in patients with cystic fibrosis,26–28 chronic pancreatitis,29 fat malabsorption due to HIV30 and improve digestion in normal patients consuming a fatty meal 31. PEZ has recently been reported as being effective for the postprandial IBS-D condition32 and among patients identified with pancreatic insufficiency who also have IBS 33.…”

Section: Introductionmentioning

confidence: 99%

Pilot study: a randomised, double blind, placebo controlled trial of pancrealipase for the treatment of postprandial irritable bowel syndrome-diarrhoea

Money

Walkowiak

Virgilio

et al. 2010

Frontline Gastroenterol

View full text Add to dashboard Cite

ObjectiveTo evaluate the efficacy of pancrealipase (PEZ) compared with placebo in the reduction of postprandial irritable bowel syndrome-diarrhoea (IBS-D).DesignAn intention to treat, double blind, randomised, crossover trial comparing PEZ to placebo for reduction of postprandial IBS-D. Patients had to recognise at least two different triggering foods, be willing to consume six baseline ‘trigger meals’ and again blinded with PEZ and placebo. Patients then chose which drug they preferred for another 25 meals.SettingOutpatient internal medicine practice clinic.Patients255 patients were screened; 83 met the criteria, including 5 years of symptoms, recognised ‘food triggers’, no other identifiable cause for the symptoms, either a normal colonoscopy or barium enema while symptomatic and able to discontinue all anticholinergic medications. 69 patients were enrolled, 20 withdrew before randomisation, leaving 49 patients: 14 men, 35 women, mean age 52 years (SD 15.3). Over 60% had experienced symptoms for 11–30 years and 16% for more than 40 years.InterventionsAfter completing six baseline meals, patients were randomised in blocks of four to receive either identical PEZ or a placebo for another six meals, and after a washout period of time received the alternative drug.Main outcome measuresThe primary analysis was number of patients who chose PEZ over placebo for the extended use.ResultsOverall, 30/49 (61%) would have chosen PEZ (p=0.078), with first drug preference for PEZ at 0.002. Among the PEZ subgroup, PEZ use compared with placebo, demonstrated improvement in all symptoms (p≤0.001) for cramping, bloating, borborygami, urge to defecate, global pain and decrease stooling with increase in stool firmness.ConclusionsPEZ was found in a small group of patients to reduce postprandial IBS-D symptoms and deserves further evaluation.

show abstract

Section: Introductionmentioning

confidence: 99%

Pilot study: a randomised, double blind, placebo controlled trial of pancrealipase for the treatment of postprandial irritable bowel syndrome-diarrhoea

Money

Walkowiak

Virgilio

et al. 2010

Frontline Gastroenterol

View full text Add to dashboard Cite

show abstract

“…This leads to a delayed activation of lipase with less activity in the proximal small intestine, causing suboptimal utilization of enzyme activity and resorption capacity [40, 42, 43]. Additionally, bile acid precipitation may affect the enterohepatic cycling of bile [44]. Proton pump inhibitors (PPI) do not have a direct inhibitory effect on pancreatic acinar cells.…”

Section: Acid Suppressionmentioning

confidence: 99%

Endoscopic and Conservative Management of Chronic Pancreatitis and Its Complications

et al. 2019

View full text Add to dashboard Cite

show abstract

“…2,3 In addition, in the acidic duodenal milieu, bile salt precipitation and subsequent adsorption to undigested food reduces the bile salt pool. 4,5 And finally, CP patients are believed to have a defect in ileal mucosal absorption of bile salts, effectively reducing the availability of bile salts for enterohepatic circulation. 6 A final factor contributing to pancreatic steatorrhea is the presence of neurohormonal disturbances resulting in gallbladder hypomotility and accelerated gastric and intestinal transit [7][8][9] (see section on Motility).…”

Section: Dovepressmentioning

confidence: 99%

Delayed release pancrelipase for treatment of pancreatic exocrine insufficiency associated with chronic pancreatitis

Krishnamurty

Rabiee

Andersen³

2009

TCRM

View full text Add to dashboard Cite

Bile Salt Malabsorption in Pancreatic Insufficiency Secondary to Alcoholic Pancreatitis

Cited by 40 publications

References 27 publications

Pilot study: a randomised, double blind, placebo controlled trial of pancrealipase for the treatment of postprandial irritable bowel syndrome-diarrhoea

Pilot study: a randomised, double blind, placebo controlled trial of pancrealipase for the treatment of postprandial irritable bowel syndrome-diarrhoea

Endoscopic and Conservative Management of Chronic Pancreatitis and Its Complications

Delayed release pancrelipase for treatment of pancreatic exocrine insufficiency associated with chronic pancreatitis

Contact Info

Product

Resources

About