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Causes of Exocrine Pancreatic Insufficiency Other Than Chronic Pancreatitis

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KUNOVSKÝ Lumír DÍTĚ Petr JABANDŽIEV Petr EID Michal POREDSKÁ Karolina VACULOVÁ Jitka SOCHOROVÁ Dana JANEČEK Pavel TESAŘÍKOVÁ Pavla BLAHO Martin TRNA Jan HLAVSA Jan KALA Zdeněk

Rok publikování 2021
Druh Článek v odborném periodiku
Časopis / Zdroj Journal of Clinical Medicine
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
www https://www.mdpi.com/2077-0383/10/24/5779#cite
Doi http://dx.doi.org/10.3390/jcm10245779
Klíčová slova exocrine pancreatic insufficiency; pancreatic enzyme replacement therapy; pancreatic cancer; cystic fibrosis; pancreatic resection; surgery; diabetes; celiac disease; inflammatory bowel disease; microbiome
Popis Exocrine pancreatic insufficiency (EPI), an important cause of maldigestion and malnutrition, results from primary pancreatic disease or is secondary to impaired exocrine pancreatic function. Although chronic pancreatitis is the most common cause of EPI, several additional causes exist. These include pancreatic tumors, pancreatic resection procedures, and cystic fibrosis. Other diseases and conditions, such as diabetes mellitus, celiac disease, inflammatory bowel disease, and advanced patient age, have also been shown to be associated with EPI, but the exact etiology of EPI has not been clearly elucidated in these cases. The causes of EPI can be divided into loss of pancreatic parenchyma, inhibition or inactivation of pancreatic secretion, and postcibal pancreatic asynchrony. Pancreatic enzyme replacement therapy (PERT) is indicated for the conditions described above presenting with clinically clear steatorrhea, weight loss, or symptoms related to maldigestion and malabsorption. This review summarizes the current literature concerning those etiologies of EPI less common than chronic pancreatitis, the pathophysiology of the mechanisms of EPI associated with each diagnosis, and treatment recommendations.

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