Review article: enzyme supplementation in cystic fibrosis, chronic pancreatitis, pancreatic and periampullary cancer

Imrie, C.W., Connett, G., Hall, R.I. and Charnley, R.M. (2010) Review article: enzyme supplementation in cystic fibrosis, chronic pancreatitis, pancreatic and periampullary cancer. Alimentary Pharmacology and Therapeutics, 32 (SUPPL. 1), 1-25. (doi:10.1111/j.1365-2036.2010.04437.x).

Abstract

Background: Over 11 000 UK patients each year develop pancreatic exocrine insufficiency - the major causes are not rare: cystic fibrosis (>300 new cases/year), pancreatic cancer (>7000 new cases/year) and chronic pancreatitis (>4000 new cases/year). Affected patients present in diverse ways, and for chronic pancreatitis, diagnosis is frequently made rather late in the course of the disease. Aim: To raise awareness of key clinical issues specific to patients with pancreatic exocrine insufficiency through experience from UK clinicians, and to offer advice regarding appropriate treatment with pancreatic enzymes. Methods: Three case studies describe clinical issues relating to pancreatic enzyme supplementation that may lead to underuse in patients with cystic fibrosis, pancreatic and periampullary cancer or chronic pancreatitis. Results: The efficacy of the treatment of exocrine pancreatic insufficiency is dependent on adequate meal:time enzyme replacement therapy. Improvements in patients' weight and nutritional status are what is aimed for - an important reason for all doctors, nurses and dieticians to give this therapy close attention. Conclusions: Pancreatic exocrine insufficiency may result in malnutrition, but enzyme supplementation can greatly improve quality of life in these patients.

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Contributors

Author: G. Connett

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