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Pancreatic enzyme replacement

Hazel M Ní Chonchubhair, Yasir Bashir, Mark Dobson, Barbara M Ryan, Sinead N Duggan, Kevin C Conlon
BACKGROUND: Small intestinal bacterial overgrowth (SIBO) is a condition characterised by symptoms similar to pancreatic exocrine insufficiency (PEI) in chronic pancreatitis patients. SIBO is thought to complicate chronic pancreatitis in up to 92% of cases; however, studies are heterogeneous and protocols non-standardised. SIBO may be determined by measuring lung air-expiration of either hydrogen or methane which are by-products of small bowel bacterial fermentation of intraluminal substrates such as carbohydrates...
February 24, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Samuel Han, Boskey Patel, May Min, Lisa Bocelli, Joan Kheder, Amy Wachholtz, Wahid Wassef
OBJECTIVES: The aim of this study was to evaluate the impact of smoking on quality of life in patients with chronic pancreatitis. METHODS: This is a cross-sectional study of chronic pancreatitis patients followed at a single institution comparing smokers with non-smokers. The primary outcome was quality of life and secondary outcomes included demographics, drug and alcohol use, anxiety and depression, pain level, nutritional status, and metabolic factors. RESULTS: 48 smokers and 45 non-smokers participated in this study...
February 26, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Aris Giannakopoulos, Anni Katelaris, Maria Noni, Theodore Karakonstantakis, Christina Kanaka-Gantenbein, Stavros Doudounakis
Patients with cystic fibrosis (CF) commonly present with an elevated TSH concentration, suggesting subclinical hypothyroidism. Its relation to concomitant pancreatic insufficiency and its natural course upon initiation of enzyme replacement have not been adequately studied. Herein, we investigated the thyroid function in newly diagnosed infants with CF and monitored the course of thyroid function response to pancreatic enzyme substitution treatment. Fourteen, newly diagnosed infants with CF and pancreatic insufficiency, were followed every 6-8 weeks for 6 months ensuing onset of pancreatic enzyme substitution therapy...
February 27, 2018: European Journal of Pediatrics
J Enrique Domínguez-Muñoz, Mary Phillips
Malnutrition is a frequent complication in patients with chronic pancreatitis. Maldigestion as a consequence of pancreatic exocrine insufficiency is the major cause of malnutrition in these patients. Together with that, toxic habits and alterations of the gastroduodenal transit may play a relevant role. Malnutrition in chronic pancreatitis is associated with osteoporosis, sarcopenia, poor quality of life, and increased mortality. An adequate nutritional evaluation including anthropometric, biochemical, and morphologic parameters is recommended in these patients...
March 2018: Gastroenterology Clinics of North America
Andrea Párniczky, Maisam Abu-El-Haija, Sohail Husain, Mark Lowe, Grzegorz Oracz, Miklós Sahin-Tóth, Flóra K Szabó, Aliye Uc, Michael Wilschanski, Heiko Witt, László Czakó, Tassos Grammatikopoulos, Ib Christian Rasmussen, Robert Sutton, Péter Hegyi
BACKGROUND: Pediatric pancreatitis is an underdiagnosed disease with variable etiology. In the past 10-15 years the incidence of pediatric pancreatitis has increased, it is now 3.6-13.3 cases per 100,000 children. Up-to-date evidence based management guidelines are lacking for the pediatric pancreatitis. The European Pancreatic Club, in collaboration with the Hungarian Pancreatic Study Group organized a consensus guideline meeting on the diagnosis and management of pancreatitis in the pediatric population...
January 4, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Kentaro Nakamura, Kazuhiko Fukatsu, Akina Sasayama, Taketo Yamaji
It has been demonstrated that an immune-modulating enteral formula enriched with whey peptides and fermented milk (IMF) had anti-inflammatory effects in some experimental models when it was administered before the induction of inflammation. Here, we investigated the anti-inflammatory effects of the IMF administration after the onset of systemic inflammation and investigated whether the IMF could improve the remote organ injuries in an acute pancreatitis (AP) model. Mice were fasted for 12 hours and then fed a choline-deficient and ethionine-supplemented diet (CDE diet) for 24 hours to induce pancreatitis...
2018: Bioscience of Microbiota, Food and Health
Can Gan, Yan-Hua Chen, Ling Liu, Jin-Hang Gao, Huan Tong, Cheng-Wei Tang, Rui Liu
Background: Pancreatic enzyme replacement therapy (PERT) is widely applied to patients with exocrine pancreatic insufficiency (EPI), but its effect and safety has not been quantified. Therefore we performed a meta-analysis to determine the efficacy and tolerance of PERT on patients with EPI. Materials and Methods: PubMed, Medline, Cochrane library database, Evidence-based medicine/clinical trials published before December 2016 were searched by two independent reviewers to identify prospective randomized controlled trials (RCTs)...
November 7, 2017: Oncotarget
Daniel Gelfond, Sonya L Heltshe, Michelle Skalland, James E Heubi, Margaret Kloster, Daniel H Leung, Bonnie W Ramsey, Drucy Borowitz
OBJECTIVES: To describe pancreatic enzyme practices during the first year of life in infants with cystic fibrosis (CF) and evaluate associations between dosing and outcomes, including growth and gastrointestinal symptoms. METHODS: We analyzed data from a subset of infants who were in a prospective cohort study conducted at 28 US CF centers. Anthropometric measurements and medications were recorded at each visit. Diaries with infant diet, pancreatic enzyme replacement therapy (PERT) dosing, stool frequency and consistency and pain were completed by a parent/guardian for three days prior to each visit...
November 15, 2017: Journal of Pediatric Gastroenterology and Nutrition
Filippo Antonini, Stefano Crippa, Massimo Falconi, Giampiero Macarri, Raffaele Pezzilli
Exocrine pancreatic insufficiency (EPI) is one of the possible mechanisms of fat maldigestion following gastric surgery, together with reduced food intake, loss of gastric reservoir, small bowel bacterial overgrowth and rapid small bowel transit. Oral pancreatic enzyme replacement therapy (PERT) is the mainstay of treatment for EPI. The efficacy and safety of pancreatic enzyme substitution in patients following gastric resection remains unclear. This review article summarizes relevant studies addressing PERT after gastric resection...
January 2018: Digestive and Liver Disease
(no author information available yet)
No abstract text is available yet for this article.
November 21, 2017: JAMA: the Journal of the American Medical Association
Tingting Xia, Xichen Chai, Jiaqing Shen
BACKGROUND: Appetite loss is one complication of chronic heart failure (CHF), and its association with pancreatic exocrine insufficiency (PEI) is not well investigated in CHF. AIM: We attempted to detect the association between PEI and CHF-induced appetite. METHODS: Patients with CHF were enrolled, and body mass index (BMI), left ventricular ejection fraction (LVEF), New York Heart Association (NYHA) cardiac function grading, B-type natriuretic peptide (BNP), serum albumin, pro-albumin and hemoglobin were evaluated...
2017: PloS One
Miroslav Vujasinovic, Roberto Valente, Anders Thorell, Wiktor Rutkowski, Stephan L Haas, Urban Arnelo, Lena Martin, J-Matthias Löhr
Morbid obesity is a lifelong disease, and all patients require complementary follow-up including nutritional surveillance by a multidisciplinary team after bariatric procedures. Pancreatic exocrine insufficiency (PEI) refers to an insufficient secretion of pancreatic enzymes and/or sodium bicarbonate. PEI is a known multifactorial complication after upper gastrointestinal surgery, and might constitute an important clinical problem due to the large number of bariatric surgical procedures in the world. Symptoms of PEI often overlap with sequelae of gastric bypass, making the diagnosis difficult...
November 13, 2017: Nutrients
Christopher Dobie, Andrew P Montgomery, Rémi Szabo, Danielle Skropeta, Haibo Yu
Sialyltransferase (ST) upregulation and the resultant hypersialylation of tumour cell surfaces is an established hallmark of many cancers including lung, breast, ovarian, pancreatic and prostate cancer. The role of ST enzymes in tumour cell growth and metastasis, as well as links to multi-drug resistance, has seen ST inhibition emerge as a target for potential antimetastatic cancer treatments. The most potent of these reported inhibitors are transition-state analogues. Although there are several examples of these in the literature, many have suspected poor pharmacokinetic properties and are not readily synthetically accessible...
November 9, 2017: Journal of Molecular Recognition: JMR
Hiroki Nishiyama, Tomoyuki Nagai, Masatoshi Kudo, Yoshihisa Okazaki, Yoshinao Azuma, Tomohiro Watanabe, Susumu Goto, Hiroyuki Ogata, Toshiharu Sakurai
Although pancreatic enzyme replacement therapy (PERT) is effective in the alleviation of pancreatic exocrine insufficiency (PEI)-related symptoms in patients with chronic pancreatitis, its mechanism of action is poorly understood. Recent studies suggest that the intestinal microbiota is associated with the pathogenesis of chronic pancreatitis. Therefore, we hypothesized that PERT exerts its effect by modifying the intestinal microbiota in addition to its presumed role in promoting fat and protein absorption...
October 26, 2017: Biochemical and Biophysical Research Communications
Vikesh K Singh, Mark E Haupt, David E Geller, Jerry A Hall, Pedro M Quintana Diez
Exocrine pancreatic insufficiency (EPI), an important cause of maldigestion and malabsorption, results from primary pancreatic diseases or secondarily impaired exocrine pancreatic function. Besides cystic fibrosis and chronic pancreatitis, the most common etiologies of EPI, other causes of EPI include unresectable pancreatic cancer, metabolic diseases (diabetes); impaired hormonal stimulation of exocrine pancreatic secretion by cholecystokinin (CCK); celiac or inflammatory bowel disease (IBD) due to loss of intestinal brush border proteins; and gastrointestinal surgery (asynchrony between motor and secretory functions, impaired enteropancreatic feedback, and inadequate mixing of pancreatic secretions with food)...
October 21, 2017: World Journal of Gastroenterology: WJG
Muhammad Shafqet, Kaveh Sharzehi
PURPOSE OF REVIEW: The emphasis of this review article is to bring to the forefront the spectrum of pancreatobiliary disorders and their association with diabetes. We hope to systematically discuss the link between diabetes and disorders of the pancreas including acute and chronic pancreatitis, as well as pancreatic cancer. We also hope to review and highlight the literature with respect to other cancers of the biliary tree including gallbladder and cholangiocarcinoma. Lastly, we discuss diabetes and biliary dyskinesia...
December 2017: Current Treatment Options in Gastroenterology
Nagesh Kamat, Ganesh Pai, Surulivel Rajan Mallayasamy, Asha Kamath, Rajasulochana S
BACKGROUND: Chronic pancreatitis (CP) is a leading cause of hospitalization among gastrointestinal diseases resulting in considerable financial burden to patients. However the direct costs for nonsurgical management in CP remains unexplored. METHODS: A cross sectional study was carried out (2011-14) in the Department of Gastroenterology, Kasturba Hospital, Manipal, India. Demographic and clinical data on laboratory investigations, interventions and follow up were obtained from the medical records department...
October 12, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
P Durie, J-D Baillargeon, S Bouchard, F Donnellan, S Zepeda-Gomez, C Teshima
Pancreatic exocrine insufficiency (PEI) results in maldigestion due to inadequate activity of pancreatic enzymes in the small bowel. PEI can arise from a variety of medical conditions that reduce enzyme synthesis within the pancreatic parenchyma or from secondary factors that may occur despite optimal parenchymal function, such as pancreatic duct obstruction or reduced or poorly synchronized enzyme release. The most characteristic symptom of PEI is steatorrhea - voluminous, lipid-rich stools; other common signs and symptoms include unexplained weight loss and deficiencies of fat-soluble vitamins and other micronutrients...
October 6, 2017: Current Medical Research and Opinion
(no author information available yet)
No abstract text is available yet for this article.
October 9, 2017: Medical Letter on Drugs and Therapeutics
Geert Roeyen, Miet Jansen, Vera Hartman, Thiery Chapelle, Bart Bracke, Dirk Ysebaert, Christophe De Block
BACKGROUND/OBJECTIVES: Studies reporting on function after pancreatic surgery are frequently based on diabetes history, fasting glycemia or random glycemia. The aim of this study was to investigate prospectively the evolution of pancreatic function in patients undergoing pancreaticoduodenectomy based on proper pre- and postoperative function tests. It was hypothesised that pancreatic function deteriorates after pancreaticoduodenectomy. METHODS: Between 2013 and 2016, 78 patients undergoing pancreaticoduodenectomy for oncologic indications had a prospective evaluation of their endocrine and exocrine pancreatic function...
September 9, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
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