Pancreatic Exocrine Insufficiency - ECAB - 1st Edition - ISBN: 9788131231920

Pancreatic Exocrine Insufficiency - ECAB

1st Edition

eBook ISBN: 9788131231920
Imprint: Elsevier India
Published Date: 29th September 2010


The exocrine pancreatic function can be impaired by many different pancreatic disease as well as diseases that do not appear to be directly linked to the exocrine pancreas. Hormones stimulating exocrine function

(e.g. CCK) might be reduced in diseases affecting the intestinal mucosa (IBD, celiac disease, AIDS) resulting in decreased exocrine secretion. The function of digestive enzymes might be affected by post-cibal asynchrony or by a decreased intraduodenal pH as in Zollinger-Ellison syndrome (ZE). An atrophy of pancreatic tissue might be caused by a lack of trophic factors, as may occur in IDDM, and pancreatic damage might occur due to drugs used for the treatment of other diseases. While some of these conditions appear to be rather rare and of minor clinical relevance, exocrine pancreatic involvement is very frequent in patients with diabetes mellitus. The diagnosis of the condition can be made by the exploration of the exocrine pancreatic secretion, which has been mainly used for the diagnosis of chronic pancreatitis and detection of pancreatic exocrine insufficiency of any etiology. Thus, diagnosis of the disease is classically based on the demonstration of either the morphological and/or the functional changes that typically develop over time in the course of the disease. Exocrine pancreatic function impairs progressively as chronic pancreatitis develops. Thus, exocrine pancreatic dysfunction refers to a mild, moderate or severe reduction of the exocrine pancreatic secretion. Finally, pancreatic function becomes insufficient to maintain a normal digestive process. Pancreatic exocrine insufficiency refers to the stage of maldigestion and malabsorption of nutrients as a consequence of a primarily and/or secondarily impaired exocrine pancreatic function. Pancreatic enzymes remain as the cornerstone for the effective treatment of various disease pathologies resulting in pancreatic exocrine insufficiency. The rigid criteria set forth by the FDA in the

Table of Contents

Pancreatic Exocrine Insufficiency: An Overview

Exocrine Pancreatic Function Tests

Pancreatic Insufficiency in Pancreatic Disorders

Pancreatic Exocrine Insufficiency in Non-Pancreatic Disorders

Pancreatic Exocrine Insufficiency in Cystic Fibrosis and Other Congenital Disorders

Nutritional Management in Pancreatic Exocrine Insufficiency

Role of Pancreatic Enzyme Therapy in Pancreatic Exocrine Insufficiency

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