Diarrhoea due to pancreatic diseases

Comparing the Enzyme Replacement Therapy Cost in Post Pancreatectomy Patients Due to Pancreatic Tumor and Chronic Pancreatitis

“…The EPI causes poor digestion of food and poor absorption of nutrients, leading to weight loss, and steatorrhea, abdominal pain (fecal fat excretion ≥6g per day). It is also associated with deficiency of fat-soluble vitamins (A,D,E and K) , magnesium, calcium and essential fatty acids, which cause symptoms such as night blindness and osteoporosis (6,30,33,34) . The EPI is often associated with diabetes mellitus (14) .…”

“…Based on persistent signs and symptoms of malabsorption or adverse events or based on the subjective evaluation of the treating physician, the prescriber is routinely adjusting the enzyme doses. Currently there are no guidelines in clinical practice for monitoring the efficacy of enzyme replacement therapy and determining a need for dose adjustment (6,8,13) .…”

“…The BMI alone is not enough to determine the nutritional status of the patient. This population needs a detailed nutritional assessment once a poor nutritional status is one of indicators of EPI, since the loss of the exocrine function leads to poor absorption and hence weight loss (6,30,33,34) , so we can infer that our patients with pancreatitis have a more severe exocrine insufficiency. Both groups have the same follow-up and pancreatic enzyme dose.…”

Diarrea en el paciente con diabetes mellitus

“…Es importante tener en cuenta que algunos edulcorantes artificiales, por su contenido de manitol o sorbitol, pueden también ocasionar deposiciones diarreicas de características osmóticas (36,37).…”

Perfil clínico e nutricional de pacientes submetidos à ressecção pancreática em terapia de reposição de enzimas pancreáticas

“…30,40 A fim de determinar se a suplementação de enzimas pancreáticas é necessária, é preciso realizar avaliação funcional do pâncreas. 65 Pacientes com IPE que perdem peso, com excreção de gordura fecal diária de mais de 15g sob uma dieta contendo 100g de gordura por dia, e aqueles com sintomas de esteatorreia são considerados elegíveis para a terapia de reposição enzimática. 28 Embora a relevância da desnutrição subclínica permaneça pouco clara, autores suportam a prescrição de terapia de substituição enzimática em todos os pacientes com IPE e má digestão de gordura, independentemente do grau de esteatorreia e a presença ou ausência de sintomas associados, a fim de evitar déficits nutricionais potencialmente relevantes.…”