What to do when a patient with exocrine pancreatic insufficiency does not respond to pancreatic enzyme substitution, a practical guide.

@article{Lankisch1999WhatTD,
  title={What to do when a patient with exocrine pancreatic insufficiency does not respond to pancreatic enzyme substitution, a practical guide.},
  author={Paul Georg Lankisch},
  journal={Digestion},
  year={1999},
  volume={60 Suppl 1},
  pages={97-103}
}
In the majority of patients, pancreatin microsphere preparations containing 25,000-40,000 FIP units of lipase will lead to a clinical improvement and reduction of steatorrhea in patients with exocrine pancreatic insufficiency. In patients failing to respond, the following stepwise procedure is recommended: increasing enzyme dosage; checking the patient's compliance; reevaluating the diagnosis; and as a last resort to decrease fat intake or adding H2-blockers or proton pump inhibitors. Although… CONTINUE READING