Alp Yildiz
Ankara University,Turkey
Title: Efficiency of Enteric-Coated Mini-Microsphere Pancreatin product on fat absorbtion and nutritional status of patients with exocrine pancreatic insufficiency due to chronic pancreatitis
Biography
Biography: Alp Yildiz
Abstract
Introduction
Pancreatic enzyme preperations are a life-saving substitution for a pivotal physiological function of the entire organism that is impaired in chronic pancreatitis with exocrine pancreatic insufficiency. Pancreatic enzyme preperations, generically called pancreatin, are not alike. Rather, they present a broad variety of pancreatin composition. Our aim with this study is to compare efficacy of enteric-coated mini-microsphere pancreatin product in respect with regular pancreatin products as the clinical outcome and symptomatic improvement of patient and beneficial effect especially on nutritional status in patients with exocrine pancreatic insufficiency.
Patients and Methods
A total of 53 consecutive patients (34 male, 19 female) with exocrine pancreatic defficiency due to chronic pancreatitis were included the study. 24 patients were treated with regular pancreatin products(Group1), 29 patients were treated with enteric-coated minimicrosphere pancreatin product (Group 2) . Symptoms, quality of life, nutritional status, pancreatic function were assessed before and after treatment. Quality of life was assessed with The Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System as a collection of health-related quality of life (HRQOL) questionnaires targeted to the management of chronic illness.
Results: Steatorrhea incidence was significantly lower in Group 2 compaared with Group1 (p<0.05). Abdominal pain score was significantly lower in Group 2 compared with Group1 (p<0.05). Median FACIT score of Group 2 was significantly higher than Group 1 (p<0.05). Median BMI was significantly increased in Group 2 in respect to Group 1 (p<0.05).
Discussion: Exocrine pancreatic insufficiency is a serious condition which occurs in several diseases including chronic pancreatitis , cystic fibrosis, pancreatic cancer, and as a result of pancreatic surgery. The lack or absence of pancreatic enzymes leads to an inadequate absorption of fat, proteins, and carbohydrates, causing steatorrhoea and creathorrhea which results in abdominal discomfort, weight loss, and nutritional deficiencies. To avoid malnutrition related morbidity and mortality, it is pivotal to commence pancreatic enzyme replacement therapy as soon as exocrine pancreatic insufficiency is diagnosed. Factors as early acidic inactivation of ingested enzymes, under dosage, and patient incompliance may prevent normalisation of nutrient absorption, in particular of fat digestion.
The most important aspect of the major therapy seems to be bioavailability of the product to enhance optimal absorbtion of food and especially fat. Enteric-coated mini-microsphere pancreatin product is shown more efffective in this study