Clinical features of different variants of excretory pancreatic insufficiency

Abstract

Aim. To analyse course of excretory pancreatic insufficiency (EPI) of pancreatic and not origin as well as factors associated with its development. Material and methods. A total of 139 patients with chronic pancreatitis or malabsorption were examined. The pancreatic function was assessed by the results of elastase test - concentration of pancreatic elastase 1 in the feces. EPI was detected in 57 patients (fecal pancreatic elastase 1 under 200 mcg/g); 38 patients had chronic pancreatitis and absolute EPI, 19 patients had relative EPI (the elastase was low, pancreatic pathology was absent, but other gastroenterological diseases were present - enteropathy, Crohns disease, previous surgery). Results. Pancreatic insufficiency in patients with pancreatitis was 36.5%. It was associated with the disease duration. Diarrhial and asthenic syndromes, normal or low lipase levels in the serum were found. Patients with relative insufficiency were significantly younger, had shorter disease duration, more frequent diarrhea, were thinner. Correction of diarrheal syndrome was more successful in patients with absolute insuffuiciency. Pancreatic elastase concentration in the feces persisted for a year in patients with absolute EPI and normalized in patients with enteropaties after etiotropic and pathogenetic therapy.

Keywords

• excretory insufucuency
• pancreas
• pancreatic elastase
• chronic pancreatitis