Study on Pancreatic Insufficiency (Chronic Pancreatitis) and Steatorrhea in Japanese Patients with Low Fat Intake

Abstract

The incidence of steatorrhea is said to be lower and its grade milder in Japanese because their fat intake is lower than that of Europeans and Americans. Failure to take this into account creates difficulties when attempting to compare data on pancreatic exocrine insufficiency in different countries. The authors examined the incidence and grade of steatorrhea in Japanese chronic pancreatitis (CP) patients whose daily fat intake was <40 g (25 patients) or ≥40 g (35 patients). In addition, 23 CP patients with steatorrhea and daily fecal fat excretion ≥5 g were given a pancreatic enzyme preparation at a dose 3–8 times higher than the usual dose to investigate its effect on fecal fat excretion. Among CP patients whose fat intake was <40 g, the incidence of fecal fat excretion <5 g was 56% and that of fecal fat excretion ≥10 g (severe steatorrhea) was 8%. In CP patients whose fat intake was ≥40 g, the incidences were 27.9 and 34.9%, respecetively; a significant increase in the number of affected patients was noted when fat intake was ≥40 g. The fat absorption rate was 76.2% among patients whose fat intake was <40 g and 77.8% among patients whose fat intake was ≥40 g, revealing no significant difference between the two groups. The proportion of CP patients whose fat absorption rate ≦80% was 32% at a fat intake <40 g and 39% at a fat intake ≥40 g, revealing no significant difference between the two groups.

Nutrient Deficiency and Supplementation in Chronic Pancreatitis

“…Steatorrhea is defined as fecal fat excretion greater than 7 g per day during a 100-g fat challenge. 2,16 The 72-hour fecal fat test is not able to determine the cause of fat malabsorption and has limited value to patients who may have other causes of steatorrhea. This quantitative fecal fat test is also difficult to control in the outpatient or hospital setting without a metabolic kitchen.…”

“…2,[14][15][16][17][18][19] A summary of studies conducted on fatsoluble vitamin deficiencies are presented in Table 3. Studies of individual vitamin deficiencies in CP are limited with vitamins D and E appearing to be most prevalent.…”