Reduced exocrine secretions ( pancreatinin insufficiency )

Question 1

What causes reduced exocrine secretions ( pancreatin insufficiency) ?

Answer 1

cystic fibrosis, chronic pancreatitis, Zollinger-Ellison syndrome, coeliac disease, obstructive pancreatic tumours,

Question 2

What dietary advice should be given ?

Answer 2

distribute food intake between three main meals and 2-3 snacks
avoid foods that are difficult to digest; legumes, high fibre foods
do not consume alcohol
avoid reduced fat diets

Question 3

How does pancreatin supplements work ?

Answer 3

they assist with the digestion of starch, fat and protein

Question 4

How to take pancreatin ( CREON) capsules ?

Answer 4

• take with meals/snacks or immediately before or after food : pancreatin is inactivated by gastric acid
• DO NOT mix with excessively hot food or drinks: pancreatin is inactivated by heat.
• if mixed with food or liquids: do not keep for more than 1 hour
• ensure adequate hydration at all times

Question 5

What are the side effects of pancreatin ( CREON) ?

Answer 5

• GI side effects
• Irritation: perioral skin and buccal mucosa
• Excessive doses= perianal irritation, hyperuricaemia, hyperuricosuria, skin irritation and hypersensitivity when handling
• fibrosing colonopathy in cystic fibrosis with high dose pancreatin ( risk factors are male children, more severe cystic fibrosis and laxative use)