Proper usage of pancreatic enzymes.

@article{Schibli2002ProperUO,
  title={Proper usage of pancreatic enzymes.},
  author={Susanne Schibli and Peter R. Durie and Elizabeth Tullis},
  journal={Current opinion in pulmonary medicine},
  year={2002},
  volume={8 6},
  pages={
          542-6
        }
}
With the recognition of the close link between nutritional status and pulmonary function in cystic fibrosis (CF), treatment and prevention of malnutrition have become a major focus in the modern therapeutic approach for patients with CF. Thereby, pancreatic enzyme replacement therapy plays a central role. This article reviews key publications on important aspects of pancreatic enzyme replacement therapy contained in the literature over the last 12 months. New insights into the pathogenesis of… 

Pancreatic Enzyme Pharmacotherapy

The delivery of sufficient enzyme concentrations into the duodenal lumen simultaneously with meals can reduce nutrient malabsorption, improve the symptoms of steatorrhea, and in some cases alleviate the pain associated with chronic pancreatitis.

Nutrition in cystic fibrosis.

  • J. MatelC. Milla
  • Medicine
    Seminars in respiratory and critical care medicine
  • 2009
Aggressive nutritional support with adequate pancreatic replacement management should lead to both normal growth and lung function preservation, and treatment programs that place an emphasis on higher caloric intake and more aggressive nutritional management in CF patients report better outcomes.

Nutrition Management of Cystic Fibrosis in the 21st Century.

  • T. SchindlerS. MichelA. Wilson
  • Medicine
    Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition
  • 2015
Clinicians may encounter patients with cystic fibrosis in obstetrician offices, endocrine clinics, or hospital settings, owing to lung transplantation or for treatment for distal intestinal obstruction syndrome.

Pancreatic enzyme replacement therapy for people with cystic fibrosis.

The efficacy and safety of pancreatic enzyme replacement therapy in children and adults with cystic fibrosis is evaluated and the efficacy andSafety of different formulations of this therapy and their appropriateness in different age groups are compared.

Pancreatic enzyme replacement therapy for people with cystic fibrosis.

There is limited evidence of benefit from enteric-coated microspheres when compared to non-enteric coated pancreatic enzyme preparations up to one month and no evidence on the long-term effectiveness and risks associated with PERT.

Pancreatic enzyme therapy in cystic fibrosis

  • J. Dodge
  • Medicine
    Expert review of respiratory medicine
  • 2008
It is shown that in the preoccupation with control of chronic pulmonary infection, the importance of pancreatic insufficiency can be underestimated.

Pancreatic enzyme replacement therapy for people with cystic fibrosis.

A systematic review of randomised and quasi-randomised controlled trials in people of any age, with cystic fibrosis and receiving pancreatic enzyme replacement therapy, at any dosage and in any formulation, for a period of not less than four weeks, found limited evidence of benefit from enteric-coated microspheres when compared to non-enteric coated pancreatic enzymes preparations up to one month.

Pancreatic Enzyme Replacement Therapy and Coefficient of Fat Absorption in Children and Adolescents With Cystic Fibrosis

In this study population, no correlation between an enzyme dosage and the degree of fat malabsorption was found; however, a CFA below 85% was found in 24% of the measurements.

Introduction: raising awareness of pancreatic exocrine insufficiency - does your patient need enzyme supplementation?

Chronic pancreatitis is a chronic disease that affects patients in the UK in diverse ways and is frequently made rather late in the course of the disease.

Review article: enzyme supplementation in cystic fibrosis, chronic pancreatitis, pancreatic and periampullary cancer

This paper focuses on the treatment of chronic pancreatitis, a major complication of pancreatic exocrine insufficiency, which is frequently made rather late in the course of the disease.

References

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The effect of 1 year adjuvant therapy with lansoprazole, a proton pump inhibitor (PPI), on growth, fecal fat loss, body composition and lung function is evaluated.

Are Children with Cystic Fibrosis Who Are Treated With a Proton-Pump Inhibitor at Risk for Vitamin B 12 Deficiency?

Cystic fibrosis patients treated with a PPI for at least 2 years show no signs of vitamin B 12 deficiency, and vitamin B12 levels were significantly higher in both CF groups compared with the control participants.

Changes in the exocrine pancreas secondary to altered small intestinal function in the CF mouse.

The data suggest that the CF pancreas may be chronically stimulated by cAMP-mediated signals, which in turn may exacerbate protein plugging in the acinar/ductal lumen, believed to be the primary cause of destruction of the Pancreas in CF.

Diagnostic Accuracy of Fecal Elastase 1 Assay in Patients with Pancreatic Maldigestion or Intestinal Malabsorption

In patients with CF, fecal EL-1 determination is not more sensitive than FCT in identifying pancreatic maldigestion; however, feca EL- 1 assay is more specific than F CT determination in distinguishing pancreaticmaldigESTion from intestinal malabsorption.

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Young women with CF tend to overestimate their weight, and young men with CF underestimate their weight when compared with their actual body weight, which is reflected in nutritional behaviour, being a significant predictor of taking oral and enteral food supplements.

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Current research suggests that the defect in pancreatic HCO(3)(-) secretion in patients with cystic fibrosis is multifactorial and involves the alteration in the function/expression of transporters at the basolateral and luminal membrane domains of the duct cells.

Acid steatocrit: a reliable screening tool for steatorrhea

This study compared the acid steatocrit (AS) results of healthy children with those of sick children with and without gastrointestinal involvement, and found that healthy children's AS results were better than those of patients with various gastrointestinal diseases.

Aberrant CFTR-dependent HCO-3 transport in mutations associated with cystic fibrosis

It is shown that mutants reported to be associated with CF with pancreatic insufficiency do not support HCO-3 transport, and those associated with Pancreatic sufficiency show reduced H CO-3 Transport, demonstrating the importance of HCO3 transport in the function of secretory epithelia and in CF.