Diagnosis of pancreatic exocrine insufficiency in chronic pancreatitis

Layer, Jutta Keller and Peter

doi:10.3998/panc.2015.37

Cited by 6 publications

(5 citation statements)

References 39 publications

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“…For greater than 4 years of age, 500 LU/kg/meal and 250 LU/kg/snack are recommended (3) (Table 3). The ideal PERT therapy is established on its clinical effectiveness, the initial dose might be adjusted based on the clinical requirement and efficacy (2,34,(67)(68)(69).…”

Section: Pertmentioning

confidence: 99%

“…Acid suppressive therapy (i.e., PPI) to reduce acid denaturation of enzymes can be initiated (74, 75). It has been suggested that combining a proton pump inhibitor (PPI) in cystic fibrosis patients who have refractory steatorrhea not responding well to PERT will aid efficacy (34,(67)(68)(69). However, in a retrospective cohort of pediatric patients with cystic fibrosis treated with PERT jointly with PPIs, there was no statistically significant improvement (76).…”

Section: Pertmentioning

confidence: 99%

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Nutrition in children with exocrine pancreatic insufficiency

Zheng

Mostamand

2023

Front. Pediatr.

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Exocrine pancreatic insufficiency (EPI) is a condition defined as pancreatic loss of exocrine function, including decreased digestive enzymes and bicarbonate secretion, which leads to maldigestion and malabsorption of nutrients. It is a common complication in many pancreatic disorders. If left undiagnosed, EPI can cause poor digestion of food, chronic diarrhea, severe malnutrition and related complications. Nutritional status and fat-soluble vitamins should be carefully assessed and monitored in patients with EPI. Early diagnosis of EPI is clinically important for appropriate nutritional support and initiating pancreatic enzyme replacement therapy (PERT) which could significantly improve patient outcomes. The evaluation of nutritional status and related unique management in children with EPI will be discussed in this review.

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Section: Pertmentioning

confidence: 99%

Section: Pertmentioning

confidence: 99%

Nutrition in children with exocrine pancreatic insufficiency

Zheng

Mostamand

2023

Front. Pediatr.

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“…In healthy individuals, the concentration of SE is >200 µg/g, and a concentration of <200 µg/g is indicative of PEI [6]. PEI was considered severely reduced if SE levels were <100 µg/g [14,15].…”

Section: Stool Elastase Level Measurementmentioning

confidence: 99%

“…Pancreatic exocrine insufficiency (PEI) and nutritional factors are also associated with survival in patients with pancreatic cancer [3,4]. Obstruction of the pancreatic duct by tumor growth can lead to pancreatic fibrosis [5]; this causes progressive destruction of functioning pancreatic tissue, resulting in indigestion and malabsorption and ultimately increasing the risk of nutritional deficiencies [6]. In many cases, malnutrition has negative effects on the quality of life and efficacy of tumor therapy, which in turn increases morbidity and mortality [7].…”

Section: Introductionmentioning

confidence: 99%

Stool Elastase as an Independent Prognostic Factor in Patients with Pancreatic Head Cancer

Hwang

Kim

Sohn

et al. 2022

JCM

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(1) Background: Patients with pancreatic exocrine insufficiency (PEI) have an increased risk of malnutrition, which in turn increases morbidity and mortality and is frequent in pancreatic head cancer. This study aimed to analyze the utility of PEI measured using the stool elastase (SE) level to predict the prognosis of patients with pancreatic head cancer. (2) Methods: Patients who underwent pancreaticoduodenectomy for pancreatic cancer at our institution between 2011 and 2015 were included. Only patients with data on preoperative SE levels were analyzed. Patients were classified into low and high SE groups based on preoperative SE levels (low < 100 µg/g < high). (3) Results: The median preoperative SE level was 67.2 µg/g, and 84 of 143 (58.7%) patients were included in the low SE group. The two groups had significantly different overall survival (OS) and disease-free survival (DFS), and the low SE group had a worse prognosis. In multivariate analysis, SE level < 100 µg/g and lymph node metastasis were independent poor prognostic factors for OS and DFS. (4) Discussion: PEI measured using SE levels is an independent prognostic factor in patients with pancreatic head cancer undergoing pancreaticoduodenectomy. Since poor nutritional status may be related to prognosis in patients with low levels of stool elastase preoperatively, aggressive treatment may be required.

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“…Pancreatic exocrine insufficiency (PEI) is characterised by a deficiency of exocrine pancreatic enzymes which results in malabsorption, malnourishment, and nutrient deficiencies of fat-soluble vitamins. PEI usually precedes DM in chronic pancreatitis but can often be underdiagnosed and undertreated [27]. Malabsorption symptoms include abdominal pain, flatulence, weight loss, and steatorrhea.…”

Section: Pancreatic Exocrine Insufficiencymentioning

confidence: 99%

Diabetes and Chronic Pancreatitis: Considerations in the Holistic Management of an Often Neglected Disease

Johnston

Thompson

McKee

et al. 2019

Journal of Diabetes Research

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Diabetes secondary to chronic pancreatitis (CP) or type 3cDM refers to a brittle form of diabetes and is often characterised by hypoglycaemic episodes, erratic glycaemic control, and impaired quality of life. It differs from other forms of diabetes and is typically characterised by concurrent pancreatic endocrine and exocrine insufficiency which can present as malabsorption and nutritional deficiencies. In this review, we discuss the pathogenesis, epidemiology, and the practicalities of diagnosis, screening, and management of this condition.

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Diagnosis of pancreatic exocrine insufficiency in chronic pancreatitis

Cited by 6 publications

References 39 publications

Nutrition in children with exocrine pancreatic insufficiency

Nutrition in children with exocrine pancreatic insufficiency

Stool Elastase as an Independent Prognostic Factor in Patients with Pancreatic Head Cancer

Diabetes and Chronic Pancreatitis: Considerations in the Holistic Management of an Often Neglected Disease

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