Presentation
In the present study, the number of patients with MODY3 who had CEL mutations was low, not allowing reliable statistical evaluation. [care.diabetesjournals.org]
Enzyme replacement therapy for pancreatic insufficiency: present and future. Clin Exp Gastroenterol. 2011:4:55-73. 2. Keller J, Layer P. Human pancreatic exocrine response to nutrients in health and disease. Gut. 2005;54(suppl 6):vi1-vi28. 3. [identifyepi.com]
Enzyme replacement therapy for pancreatic insufficiency: present and future. Clin Exp Gastroenterol. 2011. 4:55-73. [Medline]. [Full Text]. Dominguez-Munoz JE. [emedicine.medscape.com]
Pipeline Analysis (Phase II and I) Tabular Presentation 3.7. Competitive Analysis 4. Global Exocrine Pancreatic Insufficiency Market- By Therapeutics 2013-2023 (US Mn) 4.1. Overview 4.2. Pancreatic Enzyme Replacement Therapy (PERT) Drugs 4.2.1. [gii.co.jp]
The commonly used exocrine pancreatic function tests (PFT) tests are presented below. [pancreas.imedpub.com]
Entire Body System
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Laboratory Technician
However, the odious nature of this test, for both patients and laboratory technicians, makes it an unpopular choice. Of the remaining indirect function tests, faecal elastase-1 and serum trypsinogen tests are most commonly used. [mja.com.au]
Gastrointestinal
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Abdominal Pain
Stomach Pain When partially digested food has to pass through the digestive system it causes abdominal pain or discomfort. [healthline.com]
For example, the history of abdominal pain, bad smelling bowel movements and weight loss clinically suggests a diagnosis of exocrine pancreatic insufficiency. Blood tests may be ordered to check vitamin levels and pancreatic enzymes. [medicinenet.com]
Other symptoms may also include abdominal pain, flatulence and weight loss in adults, or lack of weight gain in children. [mja.com.au]
pain and GI symptoms. [gut.bmj.com]
Symptoms of PEI include: Chronic diarrhea Abdominal pain Steatorrhea (excessive fat in the feces) Flatus Azotorrhea (excessive discharge of nitrogenous substances in the feces Glucose intolerance Signs associated with certain vitamin deficiencies Anorexia [enzyme-facts.com]
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Chronic Diarrhea
Symptoms of PEI include: Chronic diarrhea Abdominal pain Steatorrhea (excessive fat in the feces) Flatus Azotorrhea (excessive discharge of nitrogenous substances in the feces Glucose intolerance Signs associated with certain vitamin deficiencies Anorexia [enzyme-facts.com]
Similarly, PERT reduced chronic diarrhea from 4 to 1 stools/day in 90% of patients with celiac disease in 2 other uncontrolled studies[ 135, 141 ]. [wjgnet.com]
J Med Genet 35 : 255 –257, 1998 Scire G, Magliocca FM, Cianfarani S, Scalamandre A, Petrozza V, Bonamico M: Autoimmune polyendocrine candidiasis syndrome with associated chronic diarrhea caused by intestinal infection and pancreas insufficiency. [care.diabetesjournals.org]
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Fecal Incontinence
Individuals with steatorrhea sometimes experience fecal incontinence or oily leakage. Intestinal gas and bloating can also occur from the fermentation of undigested food in the colon. [badgut.org]
Musculoskeletal
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Osteopenia
[…] acid. 10 EPI from CP is frequently experienced as diarrhoea, abdominal discomfort and/or pain, weight loss and grossly as steatorrhoea (strictly, 7 g fat in stool/24 hours). 1 Intermediate and long-term malnutrition from EPI increases the incidence of osteopenia [gut.bmj.com]
As a consequence of fat malabsorption, fat-soluble vitamins are insufficiently absorbed so that patients may exhibit low vitamin D levels and develop osteopathy, i.e. osteopenia, osteoporosis and osteomalacia. [pancreapedia.org]
Neurologic
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Peripheral Neuropathy
These nutrient deficiencies rarely result in symptoms such as tetany, glossitis, peripheral neuropathy and osteoporosis. B. History Part 2: Prevalence: Pancreatic insufficiency can develop due to: 1. [cancertherapyadvisor.com]
Urogenital
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Incontinence
Individuals with steatorrhea sometimes experience fecal incontinence or oily leakage. Intestinal gas and bloating can also occur from the fermentation of undigested food in the colon. [badgut.org]
Workup
Diagnosis). [6] A complete laboratory evaluation (including pancreatic function testing) is required not only to diagnose EPI but also to determine the extent of the malabsorption and assess the manifestations of the underlying disease, if present (see Workup [emedicine.medscape.com]
Other Pathologies
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Pancreatic Duct Obstruction
However, many other causes and conditions may be implicated, including cystic fibrosis, pancreatic duct obstruction, gastric and pancreatic surgery, diabetes mellitus and other conditions. [ajmc.com]
Pancreatic duct obstruction - strictures, stones, malignancy 3. [cancertherapyadvisor.com]
Treatment
Has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. [drugs.com]
“The goal of EPI treatment is to replace the digestive function of the pancreas,” Dr. Gardner says. Here's how the three elements of EPI treatment can help do this. [everydayhealth.com]
What is the treatment for exocrine pancreatic insufficiency (EPI)? The treatment for exocrine pancreatic insufficiency is termed pancreatic enzyme replacement therapy (PERT). [medicinenet.com]
The most effective treatment for exocrine pancreatic insufficiency is to successfully treat the underlying condition causing the enzyme insufficiency. [gii.co.jp]
Pancreatic replacement therapy in the treatment of pancreatic steatorrhea. Gut 4:217, 1963. Google Scholar 16. Handelsman, M. B., Golden, L. A., and Pratt, J. H. [link.springer.com]
Prognosis
What is the prognosis for a person with exocrine pancreatic insufficiency (EPI)? The prognosis of patients with exocrine pancreatic insufficiency depends upon the underlying cause. [medicinenet.com]
Prognosis and Patient Counseling. The prognosis is generally good with compliance of pancreatic enzyme supplementation. Patients need counselling and education about the right way to take enzymes and titration of doses according to symptoms. [cancertherapyadvisor.com]
Features of Alagille syndrome in 92 patients: frequency and relation to prognosis. Hepatol. Baltim. Md 29, 822–829 (1999). 4. Golson, M. L., Loomes, K. M., Oakey, R. & Kaestner, K. H. [nature.com]
[…] is a common lethal genetic disorder that is primarily diagnosed at birth through newborn screening. 2, 65 About 85% of cystic fibrosis patients have pancreatic insufficiency by early childhood. 12 Prolonged, untreated PEI is associated with a poorer prognosis [mja.com.au]
The study included 227 patients. [20] Epidemiology and Prognosis Because EPI has multiple possible causes and is not usually recorded as a medical statistic, its prevalence and demographics cannot be established with certainty at present. [emedicine.medscape.com]
Etiology
The etiology of this deficiency includes both pancreatic and nonpancreatic causes (see Etiology). [1] The exocrine pancreas produces 3 main types of enzymes: amylase, protease, and lipase. [2] Under normal physiologic conditions, the enzymes (specifically [emedicine.medscape.com]
They are organised into groups, and further divided into clinical, etiological or histopathological sub-types. [orpha.net]
However, some of the underlying etiologies (i.e. malignancy, recent surgeries) may result in the need for skilled nursing care. F. Prognosis and Patient Counseling. [cancertherapyadvisor.com]
Its etiology is probably multifactorial. Insufficient caloric intake and malnutrition present important problems. [nature.com]
Evidence from clinical research on EPI in less common etiologies is scanty and precludes firm recommendations on management. [wjgnet.com]
Epidemiology
Epidemiology of chronic pancreatitis: burden of the disease and consequences. United European Gastroenterol J. 2014 Oct;2(5):345-54. Available online at . Accessed on 3/19/17. Schneider, A. et. al. (2005 May). [labtestsonline.it]
The epidemiology and impact of pancreatic diseases in the United States. Curr Gastroenterol Rep. 2005 May. 7(2):90-5. [Medline]. de la Iglesia D, Vallejo-Senra N, Lopez-Lopez A, et al. [emedicine.medscape.com]
Spanier, BWM, Dijkgraaf, MGW & Bruno, MJ ( 2008 ) Epidemiology, aetiology and outcome of acute and chronic pancreatitis: an update. Best Pract Res Clin Gastroenterol 22, 45 – 63. 8. [cambridge.org]
Pathophysiology
Pathophysiology involved in pancreatic exocrine insufficiency The pathophysiology involved in pancreatic exocrine insufficiency is nothing but alteration of normal physiology or the diseased pancreas per se secreting less enzymes. [ispub.com]
Pathophysiology The GI tract is responsible for digesting and absorbing food. [7] Lipids provide the richest source of energy for the body, with 9 calories in every gram of fat; in comparison, carbohydrate and protein contains 4 calories per gram. [emedicine.medscape.com]
One possible cause for these symptoms is exocrine pancreatic insufficiency, and although several hypotheses have been proposed to explain the aetiology, the precise pathophysiological mechanisms remain to be elucidated. [pancreas.imedpub.com]
Pathophysiology/Complications Abstract OBJECTIVE —Exocrine pancreas dysfunction is seen in 10–30% of patients with type 1 and 2 diabetes. [care.diabetesjournals.org]
Pathophysiology Progressive inflammatory destruction of pancreatic tissue in chronic pancreatitis leads to reduced synthesis and secretion of pancreatic enzymes in response to food intake. [pancreapedia.org]
Prevention
This results in the prevention of breakdown of food and its absorption leading to malnutrition. [enzyme-facts.com]
Cutting the fat in your diet can also help prevent abdominal pain from underlying pancreatitis. [everydayhealth.com]
Clinical symptoms of steatorrhea are prevented when pancreatic lipase output remains greater than 10% of normal physiological output. 3,9 Postprandial synchrony—the appropriate timing and delivery of gastric contents into the duodenum and discharge of [ajmc.com]