Pancreatic Insufficiency

Health Condition

Pancreatic Insufficiency

About This Condition

Pancreatic insufficiency occurs when the pancreas does not secrete enough chemicals and digestive enzymes for normal digestion to occur.

When pancreatic insufficiency is severe, malabsorption (impaired absorption of nutrients by the intestines) may result, leading to deficiencies of essential nutrients and the occurrence of loose stools containing unabsorbed fat (steatorrhea).

Severe pancreatic insufficiency occurs in cystic fibrosis, chronic pancreatitis, and surgeries of the gastrointestinal system in which portions of the stomach or pancreas are removed. Certain gastrointestinal diseases, such as stomach ulcers,1celiac disease,2 and Crohn’s disease,3 and autoimmune disorders, such as systemic lupus erythematosus (SLE),4,5,6 may contribute to the development of pancreatic insufficiency. Mild forms of pancreatic insufficiency are often difficult to diagnose, and there is controversy among researchers regarding whether milder forms of pancreatic insufficiency need treatment.

Pancreatitis is an inflammation of the pancreas that reduces the function of the pancreas, causing pancreatic insufficiency, malabsorption, and diabetes.7 Acute pancreatitis is usually a temporary condition and can be caused by gallstones, excessive alcohol consumption, high blood triglycerides, abdominal injury, and other diseases, and by certain medications and poisons.8 Chronic pancreatitis is a slow, silent process that gradually destroys the pancreas and is most often caused by excessive alcohol consumption.

Symptoms

People with pancreatic insufficiency may have excess oil in the stool (steatorrhea), which is associated with symptoms of pale, foul-smelling, bulky stools that stick to the side of the toilet bowl or are difficult to flush, oil droplets floating in the toilet bowl after bowel movements, and abdominal discomfort, gas, and bloating. People with pancreatic insufficiency may also have bone pain, muscle cramps, night blindness, and easy bruising.

Other Therapies

Some healthcare practitioners might also recommend intravenous nutritional supplements that replace unabsorbed fat-soluble vitamins, such as vitamins A, D, E, and K.

References

1. Wormsley, KG. Pancreatic exocrine function in patients with gastric ulceration before and after gastrectomy. Lancet 1972;7779:682-4.

2. Dimagno, EP, Go, VLW, Summerskill WHJ. Impaired cholecystokinin-pancreozymin secretion, intraluminal dilution, and maldigestion of fat in sprue. Gastroenterology 1972;63:25-32.

3. Hegnhoj J, Hansen CP, Rannem T, et al. Pancreatic function in Crohn's disease. Gut 1990;31:1076-9.

4. D'Ambrosi A, Verzola A, Gennaro P, et al. Functional reserve of the exocrine pancreas in Sjögren's syndrome. Recenti Prog Med 1997;88:21-5 [in Italian].

5. Dreiling DA, Soto JM. The pancreatic involvement in disseminated “collagen” disorders. Am J Gastroenterology 1976;66:546-53.

6. Watts RA, Isenberg DA. Pancreatic disease in the autoimmune rheumatic disorders. Semin Arthritis Rheum 1989;19:158-65 [review].

7. Apte MV, Keogh GW, Wilson JS. Chronic pancreatitis: complications and management. J Clin Gastroenterol 1999;29:225-40.

8. Sleisenger MH, Feldman M, Scharschmidt BF. Sleisenger & Fordtran's Gastrointestinal and Liver Disease Pathophysiology/Diagnosis/Management. Philadelphia, PA: W.B. Saunders Company, 1998, 818.

9. Scolapio JS, Malhi-Chowla N, Ukleja A. Nutrition supplementation in patients with acute and chronic pancreatitis. Gastroenterol Clin North Am 1999;28:695-707 [review].

10. Nakamura T, Tandoh Y, Terada A, et al. Effects of high-lipase pancreatin on fecal fat, neutral sterol, bile acid, and short-chain fatty acid excretion in patients with pancreatic insufficiency resulting from chronic pancreatitis. Int J Pancreatol 1998;23:63-70.

11. Schneider MU, Knoll-Ruzicka ML, Domshke S, et al. Pancreatic enzyme replacement therapy: comparative effects of conventional and enteric-coated microspheric pancreatin and acid-stable fungal enzyme preparations on steatorrhea in chronic pancreatitis. Hepatogastroenterology 1985;32:97-102.

12. Isaksson G, Ihse I. Pain reduction by an oral pancreatic enzyme preparation in chronic pancreatitis. Dig Dis Sci 1983;28:97-102.

13. Slaff J, Jacobson D, Tillman CR, et al. Protease-specific suppression of pancreatic exocrine secretion. Gastroenterol 1984;87:44-52.

14. Halgreen H, Pedersen NT, Worning H. Symptomatic effect of pancreatic enzyme therapy in patients with chronic pancreatitis. Scand J Gastroenterol 1986;21:104-8.

15. Mossner J. Is there a place for pancreatic enzymes in the treatment of pain in chronic pancreatitis? Digestion 1993;54 Suppl 2:35-9.

16. Dellhaye M, Meuris S, Gohimont AC, et al. Comparative evaluation of a high lipase pancreatic enzyme preparation and a standard pancreatic supplement for treating exocrine pancreatic insufficiency in chronic pancreatitis. Eur J Gastroenterol Hepatol 1996;8:699-703.

17. Malesci A, Mariani A, Mezzi G, et al. New enteric-coated high-lipase pancreatic extract in the treatment of pancreatic steatorrhea. J Clin Gastroenterol 1994;18:32-5.

18. Bansi DS, Price A, Russell C, Sarner M. Fibrosing colonopathy in an adult owing to over use of pancreatic enzyme supplements. Gut 2000;46:283-5.

19. Littlewood JM, Wolfe SP. Control of malabsorption in cystic fibrosis. Paediatr Drugs 2000;2:205-22.

20. Borowitz DS, Grand RJ, Durie PR. Use of pancreatic enzyme supplements for patients with cystic fibrosis in the context of fibrosing colonopathy. Consensus committee. J Pediatr 1995;127:681-4.

21. Cruz Pinho A. Dispepsia e terapeutica enzimatica de substituicao. Cadernos Generalista (Lisboa) 1990;78:43-47 [in Portugese].

22. Suarez F, Levitt MD, Adshead J, Barkin JS. Pancreatic supplements reduce symptomatic response of healthy subjects to a high fat meal. Dig Dis Sci 1999;44:1317-21.

23. Bragelmann R, Armbrecht U, Rosemeyer D, et al. The effect of pancreatic enzyme supplementation in patients with steatorrhea after total gastrectomy. Eur J Gastroenterol Hepatol 1999;11:231-7.

24. Armbrecht U, Lundell L, Stockbruegger RW. Nutrient malassimilation after total gastrectomy and possible intervention. Digestion 1987;37 Suppl 1:56-60.

25. Armbrecht U, Lundell L, Stockbrugger RW. The benefit of pancreatic enzyme substitution after total gastrectomy. Aliment Pharmacol Ther 1988;2:493-500.

26. Ghaneh P, Neoptolemos JP. Exocrine pancreatic function following pancreatectomy. Ann N Y Acad Sci 1999;880:308-18 [review].

27. Neoptolemos JP, Ghaneh P, Andren-Sandberg A, et al. Treatment of pancreatic exocrine insufficiency after pancreatic resection. Results of a randomized, double-blind, placebo-controlled, crossover study of high vs standard dose pancreatin. Int J Pancreatol 1999;25:171-80.

28. Schoenberg MH, Birk D, Beger HG. Oxidative stress in acute and chronic pancreatitis. Am J Clin Nutr 1995;62:1306S-14S [review].

29. Schulz H, Niederau C, Klonowski-Stumpe H, et al. Oxidative stress in acute pancreatitis. Hepato-Gastroenterology 1999;46:2736-2750 [review].

30. Wallig MA. Xenobiotic metabolism, oxidant stress and chronic pancreatitis. Digestion 1998;59(suppl 4):13-24 [review].

31. Rose P, Fraine E, Hunt LP, et al. Dietary antioxidants and chronic pancreatitis. Hum Nutr Clin Nutr 1986;40:151-64.

32. Morris-Stiff GJ, Bowrey DJ, Oleesky D, et al. The antioxidant profiles of patients with recurrent acute and chronic pancreatitis. Am J Gastroenterol 1999;94:2135-40.

33. Gut A, Shiel N, Kay PM, et al. Heightened free radical activity in blacks with chronic pancreatitis at Johannesburg, South Africa. Clin Chim Acta 1994;230:189-99.

34. Bonham MJ, Abu-Zidan FM, Simovic MO, et al. Early ascorbic acid depletion is related to the severity of acute pancreatitis. Br J Surg 1999;86:1296-301.

35. Tsai K, Wang SS, Chen TS, et al. Oxidative stress: an important phenomenon with pathogenetic significance in the progression of acute pancreatitis. Gut 1998;42:850-6.

36. Braganza JM, Schofield D, Snehalatha C, Mohan V. Micronutrient antioxidant status in tropical compared with temperate-zone chronic pancreatitis. Scand J Gastroenterol 1993;28:1098-104.

37. Mathew P, Wyllie R, Van Lente F, et al. Antioxidants in hereditary pancreatitis. Am J Gastroenterol 1996;91:1558-62.

38. Kulinski B, Buchner M, Schweder R, Nagel R. Acute pancreatitis—a free radical disease. Decrease in fatality with sodium selenite (Na2SeO3) therapy. Z Gesamte Inn Med 1991;46:145-9 [in German].

39. Uden S, Bilton D, Nathan L, et al. Antioxidant therapy for recurrent pancreatitis: placebo-controlled trial. Aliment Pharmacol Ther 1990;4:357-71.

40. McCloy R. Chronic pancreatitis at Manchester, UK. Focus on antioxidant therapy. Digestion 1998;59(suppl 4):36-48 [review].

41. Kirk GR, White JS, McKie L, et al. Combined antioxidant therapy reduces pain and improves quality of life in chronic pancreatitis. J Gastrointest Surg 2006;10:499-503.

42. Kulinski B, Buchner M, Schweder R, Nagel R. Acute pancreatitis—a free radical disease. Decrease in fatality with sodium selenite (Na2SeO3) therapy. Z Gesamte Inn Med 1991;46:145-9 [in German].

43. Uden S, Bilton D, Nathan L, et al. Antioxidant therapy for recurrent pancreatitis: placebo-controlled trial. Aliment Pharmacol Ther 1990;4:357-71.

44. McCloy R. Chronic pancreatitis at Manchester, UK. Focus on antioxidant therapy. Digestion 1998;59(suppl 4):36-48 [review].

45. Kulinski B, Buchner M, Schweder R, Nagel R. Acute pancreatitis—a free radical disease. Decrease in fatality with sodium selenite (Na2SeO3) therapy. Z Gesamte Inn Med 1991;46:145-9 [in German].

46. Uden S, Bilton D, Nathan L, et al. Antioxidant therapy for recurrent pancreatitis: placebo-controlled trial. Aliment Pharmacol Ther 1990;4:357-71.

47. McCloy R. Chronic pancreatitis at Manchester, UK. Focus on antioxidant therapy. Digestion 1998;59(suppl 4):36-48 [review].

48. Kulinski B, Buchner M, Schweder R, Nagel R. Acute pancreatitis—a free radical disease. Decrease in fatality with sodium selenite (Na2SeO3) therapy. Z Gesamte Inn Med 1991;46:145-9 [in German].

49. Uden S, Bilton D, Nathan L, et al. Antioxidant therapy for recurrent pancreatitis: placebo-controlled trial. Aliment Pharmacol Ther 1990;4:357-71.

50. McCloy R. Chronic pancreatitis at Manchester, UK. Focus on antioxidant therapy. Digestion 1998;59(suppl 4):36-48 [review].

51. Banerjee B, Bagchi D. Beneficial effects of a novel IH636 grape seed proanthocyanidin extract in the treatment of chronic pancreatitis. Digestion 2001;63:203-6.

52. Dutta SK, Hlasko J. Dietary fiber in pancreatic disease: effect of high fiber diet on fat malabsorption in pancreatic insufficiency and in vitro study of the interaction of dietary fiber with pancreatic enzymes. Am J Clin Nutr 1985;41:517-25.

53. Scolapio JS, Malhi-Chowla N, Ukleja A. Nutrition supplementation in patients with acute and chronic pancreatitis. Gastroenterol Clin North Am 1999;28:695-707 [review].

54. Nakamura T, Tando Y, Yamada N, et al. Study on pancreatic insufficiency (chronic pancreatitis) and steatorrhea in Japanese patients with low fat intake. Digestion 1999;60 Suppl 1:93-6.

55. Scolapio JS, Malhi-Chowla N, Ukleja A. Nutrition supplementation in patients with acute and chronic pancreatitis. Gastroenterol Clin North Am 1999;28:695-707 [review].

56. Gullo L, Barbara L, Labo G. Effect of cessation of alcohol use on the course of pancreatic dysfunction in alcoholic pancreatitis. Gastroenterology 1988;94:1063-8.

57. Kankisch PG, Lohr-Happe A, Otto J, Creutzfeldt W. Natural course in chronic pancreatitis. Pain, exocrine and endocrine pancreatic insufficiency and prognosis of the disease. Digestion 1993;54:148-55.

58. Brown P. The influence of smoking on pancreatic function in man. Med J Aust 1976;2:290-3.

59. Talamini G, Bassi C, Falconi M, et al. Cigarette smoking: an independent risk factor in alcoholic pancreatitis. Pancreas 1996;12:131-7.

60. Hart AR. Pancreatic cancer: any prospects for prevention? Postgrad Med J 1999;75:521-6 [review].

61. Lowenfels AB, Maisonneuve P, Cavallini G, et al. Prognosis of chronic pancreatitis: an international multicenter study. International pancreatitis study group. Am J Gastroenterol 1994;89:1467-71.

Copyright © 2024 TraceGains, Inc. All rights reserved.

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The information presented by TraceGains is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2024.

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