The investigation and management of pancreatic exocrine insufficiency: A retrospective cohort study.

Clinical Medicine : Journal of the Royal College of Physicians of London
Benjamin Myles ShandroAndrew Poullis

Abstract

Pancreatic exocrine insufficiency (PEI) is associated with significant gastrointestinal symptoms, but is readily treated by pancreatic enzyme replacement therapy (PERT). We reviewed our current practice and examined the factors that predict repeating a positive faecal elastase-1 (FE1; <200 μg/g), the repeat FE1 being normal, initiation of PERT and clinical response to treatment. A single-centre retrospective cohort study was conducted. Outpatients with FE1 <200 μg/g between 2012 and 2018 were included. Logistic regression was used to explore the associations with each outcome, with statistical adjustment for confounders. Two-hundred and ten patients were included; 28.1% of patients had their FE1 repeated, 47.5% of whom had a normal repeat result. Patients with initial FE1 <15 μg/g were unlikely to be reclassified on repeat testing. Patients with a confirmatory low FE1, abnormal pancreatic imaging or abnormal nutrition blood tests were more likely to be started on PERT (all p<0.05). Patients with abnormal pancreatic imaging were 10 times more likely to respond to PERT (odds ratio 10.70; 95% confidence interval 1.62-70.70; p=0.01). Augmenting clinical judgement with pancreatic imaging and repeat FE1 testing could improve the rate...Continue Reading

References

Jul 11, 2001·Scandinavian Journal of Gastroenterology·B FischerH T Schneider
May 13, 2005·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·R PezzilliL Gullo
Apr 21, 2007·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·J Enrique Domínguez-MuñozMarta Iglesias-Rey
Apr 11, 2012·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Edmée C M SikkensMarco J Bruno
Aug 29, 2014·BMJ Supportive & Palliative Care·Amanda LandersHelen Brown
Oct 1, 2016·Journal of Gastrointestinal and Liver Diseases : JGLD·Jennifer A CampbellAndrew D Hopper
Dec 13, 2016·Gut·Daniel de la Iglesia-GarcíaUNKNOWN NIHR Pancreas Biomedical Research Unit Patient Advisory Group
Mar 28, 2017·United European Gastroenterology Journal·J Matthias LöhrUNKNOWN HaPanEU/UEG Working Group
Jul 18, 2017·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Keith J RobertsDarius F Mirza
Aug 18, 2017·The Medical Journal of Australia·Mehrdad NikfarjamUNKNOWN Australasian Pancreatic Club Pancreatic Enzyme Replacement Therapy Guidelines Working Group
Nov 3, 2017·World Journal of Gastroenterology : WJG·Vikesh K SinghPedro M Quintana Diez
Jan 29, 2018·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Rohini R VangaMohamed O Othman
Nov 7, 2018·World Journal of Gastrointestinal Pharmacology and Therapeutics·Benjamin Myles ShandroAndrew Poullis

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Citations

Nov 18, 2020·Clinical Medicine : Journal of the Royal College of Physicians of London·Anton Emmanuel

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