Publication details
Aktuální diagnostika a terapie chronické pankreatitidy
| Authors | |
|---|---|
| Year of publication | 2020 |
| Type | Article in Periodical |
| Magazine / Source | Farmakoterapeutická revue |
| MU Faculty or unit | |
| Citation | |
| Web | https://farmakoterapeutickarevue.cz/cs/aktualni-diagnostika-a-terapie-chronicke-pankreatitidy |
| Keywords | chronic pancreatitis; definition of chronic pancreatitis; imaging methods; exocrine pancreatic function; pancreatic enzymatic substitution; pancreatic pain |
| Description | The diagnosis of chronic pancreatitis is currently based primarily on the use of a range of imaging methods and the assessment of exocrine pancreatic function by functional tests, which are either direct or evaluate pancreatic function indirectly. The non-invasive breath test with mixed triglycerides, the determination of fat absorption and the simple test for the determination of faecal elastase 1, most often used in clinical practice, are essential tests. In the treatment of exocrine insufficiency, so-called enteric-coated microparticles with a size of <2 mm are recommended, which are administered in a capsule with a pH-sensitive coating. This ensures synchronization between the release of the microparticles from the capsule and their mixing with the gastric chyme, so that the chyme in the upper duodenum and its digestion are affected by the action of pancreatic enzymes, especially lipase, which is released from the microparticles. The principle of therapy is to administer a sufficient dose of enzymes with each meal in the form of microparticle capsules. The effect of treatment can be assessed on the basis of changes in clinical symptoms, a reduction in the amount of fat in the stool or some tests, such as a breath test or a fat absorption test. In people with hyperacidity, treatment involves the administration of drugs that block the production of stomach acid, most often proton pump blockers. In cystic fibrosis, higher doses of enzymes are required, but particularly high doses can lead to fibrotic colonopathies. |