Monday, June 20, 2016

Pancreatic Insufficiency

Pancreatic Insufficiency

The Pancreas is an important intra-abdominal organ, which lies behind the stomach and adjacent to the first part of the small intestine. It is about six inches long and has a head and a tail. Its most important functions are to produce hormones that help regulate blood sugar levels and pancreatic juices that aid in digestion. These are known as its endocrine and exocrine functions respectively.


Pancreatic insufficiency occurs when the exocrine function is deficient so that the pancreas does not produce enough pancreatic enzymes that help digest food.





What Is Pancreatic Insufficiency?
Exocrine pancreatic insufficiency is a condition that occurs when your pancreas cannot make enough enzymes the body needs to digest the food in your small intestine. This leads to problems in digestion and nutrition intake because the body cannot break down food into nutrients that can be absorbed by the cells.


Enzymes are chemicals that speed up natural reactions in the body. Pancreatic enzymes help break down food in the small intestine to make nutrients available for absorption into the cells. A lack of digestive enzymes causes poor digestion and Malabsorption of proteins, fats, starches and other important nutrients likevitamins and minerals from food. This can lead to bloating, gas, fatty stools, Weight Loss, and abdominal pain.


Initially, you may not have symptoms, but later on, you may experience symptoms like:



  • abdominal pain/tenderness

  • feelings of fullness

  • loss of appetite

  • weight loss

  • foul-smelling bowel movements

  • Diarrhea

  • abnormal bleeding, if you do not get enough vitamin K

  • bone pain, if you do not get adequate amounts of vitamin D


What Causes Pancreatic Insufficiency?
Damage to the pancreas can lead to pancreatic insufficiency, resulting in low levels of pancreatic enzymes. This leads to malabsorption of food, which is not properly used as energy by the body.


Your pancreas may be damaged by:



  • chronic inflammation

  • pancreatic surgery

  • Cancer

  • genetic factors that may cause Cystic Fibrosis or Shwachman-Diamond Syndrome


Other factors that increase your risk for pancreatic insufficiency include:



How to Diagnose Pancreatic Insufficiency
There are several tests used to diagnose pancreatic insufficiency. Evaluation of this medical condition also includes some blood tests to check for any vitamin deficiencies. Tests to determine the underlying cause for your condition also include tests for Celiac Disease and other conditions.


A "3-day fecal test," which involves collection of stool samples for three days may be needed to assess the amount of fat in your stools. Another test called "fecal elastase-1" may also be done to look for the presence of an important digestive enzyme in your stool.


Other tests that may help find out if you have pancreatic damage or inflammation include:



  • CT scan, which uses powerful X-ray to take detailed pictures of your body.

  • MRI, which uses powerful magnetic and radio waves to examine the internal organs of your body.

  • Endoscopic ultrasound, which uses sound waves to make images of your digestive system.


Genetic testing may also be recommended to see if you have genes responsible for certain conditions that can lead to pancreatic insufficiency.


How to Treat Pancreatic Insufficiency
Fortunately, pancreatic insufficiency is treatable. One option treatment consists of replacing pancreatic enzymes with supplements that aid in digestion. This type of treatment helps improve absorption and prevent vitamin deficiencies. It also improves weight gain. Other options include home remedies like dietary modifications and pancreatic cell transplantation.


1. Medical Treatment
Pancreatic enzyme replacement therapy is the main treatment used for pancreatic insufficiency. It consists of regular intake of enzyme pills to replace deficient enzymes. These enzymes break down food for easy digestion and absorption. They are taken during meals for best results.


You may also need to take antacids to prevent premature break down of the pancreatic enzymes in the stomach before they start to work.


FDA-approved pancreatic enzymes that you can obtain with a doctor’s prescription include the following:



  • Creon

  • Pancreaze

  • Ultresa

  • Viokace

  • Pertzye

  • Zenpep


However, not all patients who have pancreatic insufficiency need these digestive enzymes. Some people who have milder forms of the disease can reduce their symptoms just by eating a healthy, low-fat diet.


For severe pancreatic insufficiency, vitamin supplements are necessary part of your treatment to treat vitamin deficiencies.


You may also need medication to treat abdominal pain. Doctors usually advise taking nonsteroidal anti-inflammatory drugs (NSAID) like ibuprofen, but if this does not bring relief, stronger pain relievers, such as oxycodone and hydrocodone may be prescribed.


2. Home Remedies
It is important for you to take care of yourself by modifying your lifestyle to prevent symptoms. Choosing the right types of food with the help of a dietitian is always advised. This will help prevent symptoms of malabsorption and at the same time provide enough energy and nutrition your body needs.



  • Eating frequent small meals rather than big meals to improve digestion.

  • Avoiding alcohol, which can damage your pancreas over time and make it more difficult for your body to absorb fat.

  • Taking vitamins A, D, E, and K to replace those that your system is not able to absorb from the diet. Consult your doctor before taking supplements.

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