TY - JOUR
T1 - Natural Course and Treatment of Pancreatic Exocrine Insufficiency in a Nationwide Cohort of Chronic Pancreatitis
AU - Kempeneers, Marinus A.
AU - Ahmed Ali, Usama
AU - Issa, Yama
AU - van Goor, Harry
AU - Drenth, Joost P. H.
AU - van Dullemen, Hendrik M.
AU - van Hooft, Jeanin E.
AU - Poen, Alexander C.
AU - van Veldhuisen, Sophie L.
AU - Besselink, Marc G.
AU - van Santvoort, Hjalmar C.
AU - Bruno, Marco J.
AU - Boermeester, Marja A.
N1 - Publisher Copyright: © 2020 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Objectives Pancreatic exocrine insufficiency (PEI) is a common complication of chronic pancreatitis. However, little is known about the natural course of PEI and the effect of pancreatic enzyme replacement therapy on symptoms. The aim of this study was to evaluate the natural course and treatment of PEI in a nationwide cohort of patients with chronic pancreatitis. Methods Patients with chronic pancreatitis were selected from the multicenter Dutch Chronic Pancreatitis Registry. Patients were classified in 3 groups: Definite PEI, potential PEI, and no PEI. Definite PEI and no PEI were compared regarding the course of disease, symptoms, treatment, and quality of life. Results Nine hundred eighty-seven patients were included from 29 centers, of which 304 patients (31%) had definite PEI; 451 (46%), potentially PEI; and 232 (24%), no PEI. Patients with definite PEI had significantly more malabsorption symptoms, a lower body mass index, and aberrant defecation. Lowered quality of life was not independently associated with PEI. Of the PEI patients using pancreatic enzyme replacement therapy, 47% still reported steatorrhea. Conclusions Pancreatic exocrine insufficiency is associated with malabsorption symptoms and a lower body mass index. Some form of pancreatic enzyme replacement therapy is reasonably effective in alleviating malabsorption symptoms, but improvement of treatment is needed.
AB - Objectives Pancreatic exocrine insufficiency (PEI) is a common complication of chronic pancreatitis. However, little is known about the natural course of PEI and the effect of pancreatic enzyme replacement therapy on symptoms. The aim of this study was to evaluate the natural course and treatment of PEI in a nationwide cohort of patients with chronic pancreatitis. Methods Patients with chronic pancreatitis were selected from the multicenter Dutch Chronic Pancreatitis Registry. Patients were classified in 3 groups: Definite PEI, potential PEI, and no PEI. Definite PEI and no PEI were compared regarding the course of disease, symptoms, treatment, and quality of life. Results Nine hundred eighty-seven patients were included from 29 centers, of which 304 patients (31%) had definite PEI; 451 (46%), potentially PEI; and 232 (24%), no PEI. Patients with definite PEI had significantly more malabsorption symptoms, a lower body mass index, and aberrant defecation. Lowered quality of life was not independently associated with PEI. Of the PEI patients using pancreatic enzyme replacement therapy, 47% still reported steatorrhea. Conclusions Pancreatic exocrine insufficiency is associated with malabsorption symptoms and a lower body mass index. Some form of pancreatic enzyme replacement therapy is reasonably effective in alleviating malabsorption symptoms, but improvement of treatment is needed.
KW - M-ANNHEIM criteria
KW - PERT
KW - pancreatic function loss
KW - undertreatment
UR - http://www.scopus.com/inward/record.url?scp=85079356146&partnerID=8YFLogxK
U2 - https://doi.org/10.1097/MPA.0000000000001473
DO - https://doi.org/10.1097/MPA.0000000000001473
M3 - Article
C2 - 32011528
SN - 0885-3177
VL - 49
SP - 242
EP - 248
JO - Pancreas
JF - Pancreas
IS - 2
ER -