| Theme |
Chronic Pancreatitis |
| Title |
Pancreatic Hypofunction |
| Author |
Yusuke Tando |
Division of Medical Life Sciences, Department of Biomedical Sciences, Hirosaki University Graduate School of Health Sciences |
| Author |
Atsufumi Matsumoto |
Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Health Sciences |
| Author |
Yuki Matsuhashi |
Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Health Sciences |
| Author |
Hikaru Tanaka |
Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Health Sciences |
| Author |
Miyuki Yanagimachi |
Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Health Sciences |
| Author |
Teruo Nakamura |
Center for Health Evaluation, Hirosaki Medical Association |
| [ Summary ] |
The exocrine pancreas has large functional reserves. Exocrine pancreatic hypofunction is due to progressive fibrotic scarring of the pancreatic parenchyma in patients with chronic pancreatitis. Pancreatic insufficiency can be diagnosed by measuring fecal fat content. However, it is difficult to diagnose slight declines in pancreatic function in the early stages. Malabsorption does not occur until pancreatic enzyme secretion is reduced to less than 10-20 % of normal. The threshold level distinguishing insufficiency from decline may not be clearly observed with popular methods of estimating pancreatic exocrine function such as the PFD test. It is also difficult to diagnose slight declines in pancreatic function with the new method for estimating pancreatic function using stable isotope 13C. Pancreatic enzyme replacement therapy is the primary treatment for patients with pancreatic insufficiency. Dietary surveys are also important because enzyme requirements depend on dietary intake. Direct supply of deficient nutrients is one treatment option for patients with overt malnutrition. |