PANCREATIC INSUFFICIENCY

Question 1

Pancreatic insufficiency

Answer 1

Reduced secretion of pancreatic enzymes into the duodenum.

Question 2

Causes of Pancreatic insufficiency

Answer 2

pancreatitis, CF, pancreatic tumours, coeliac disease, gastro-intestinal resection

Question 3

Symptoms

Answer 3

GI
abdominal cramps
steatorrhoea
diarrhoea

Question 4

Exocrine Pancreatic insufficiency - treatment

Answer 4

Pancreatic enzyme replacement (pancreatin)

Question 5

What is pancreatin?

Answer 5

lipase, amylase and protease which digest fats, carbohydrates and proteins so it can be absorbed

Question 6

Pancreatin dose

Answer 6

The dose should be adjusted as necessary to the lowest effective dose according to symptoms of maldigestion and malabsoeprion

Question 7

Pancreatin - counselling points

Answer 7

Take with meals and snacks - prevent early breakdown

Question 8

Patients with cystic fibrosis: fibrosing colonopathy at high dose pancreatin

Answer 8

• CF patients should not exceed 10000 units/kg/day of lipase
• Report any new abdominal symptoms

Question 9

Fibrosing colonpathy: RF

Answer 9

Gender - in children boys are at more risk than girls
More severe CF
Concomitant use of laxatives

Question 10

Monitoring

Answer 10

Levels of fat-soluble vitamins and micronutrients should be monitored
Give supplements when needed