Fate of pancreatic enzymes during small intestinal aboral transit in humans

1986 ◽  
Vol 251 (4) ◽  
pp. G475-G480 ◽  
Author(s):  
P. Layer ◽  
V. L. Go ◽  
E. P. DiMagno
Keyword(s):  
Enzymatic Activity ◽  
Structural Integrity ◽  
Amylase Activity ◽  
Lipolytic Activity ◽  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Insufficiency ◽  
Pancreatic Enzymes ◽  
Trypsin Activity ◽  
Tryptic Activity ◽  
Small Intestinal

To determine survival of pancreatic enzymes during small intestinal aboral transit in humans, seven healthy volunteers were intubated with an oroileal tube. By using nonabsorbable markers we measured the cumulative amount of lipase, trypsin, and amylase activities and lipase and trypsin immunoreactivities delivered postprandially to the duodenum, midjejunum, and terminal ileum. We found that as the enzymes moved from duodenum to ileum, 74% of amylase activity, 22% of trypsin activity, and 1% of lipase activity survived transit. Enzymatic activity and immunoreactivity of trypsin and lipase disappeared at different rates, suggesting that for these enzymes the sites of enzymatic activity and immunorecognition are not identical. Since tryptic activity is present even in the absence of immunorecognizable trypsin, complete structural integrity of the trypsin molecule may not be essential for its enzymatic activity. The short intraluminal survival of lipolytic activity may partially explain why patients with progressive exocrine pancreatic insufficiency malabsorb fat earlier than other nutrients.

Pancreatic enzymes for exocrine pancreatic insufficiency due to chronic pancreatitis or pancreatic surgery

2013 ◽  
Vol 17 (4) ◽  
pp. 134-139
Author(s):  
Shu Gong ◽  
Wen-Wu Shen ◽  
Qiang Guo ◽  
Hui-Min Lu ◽  
Xu-Bao Liu ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Surgery ◽  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Insufficiency ◽  
Pancreatic Enzymes

The Absorption of α-Tocopherol in Control Subjects and in Patients with Intestinal Malabsorption

1970 ◽  
Vol 38 (2) ◽  
pp. 197-210 ◽  
Author(s):  
M. T. MacMahon ◽  
G. Neale
Keyword(s):  
Biliary Obstruction ◽  
Pancreatic Insufficiency ◽  
Partial Gastrectomy ◽  
Exocrine Pancreatic Insufficiency ◽  
Small Intestinal Mucosa ◽  
Intestinal Lymphangiectasia ◽  
Intestinal Malabsorption ◽  
Control Subjects ◽  
Small Intestinal ◽  
Almost All

1. The absorption of physiological doses of tritiated α-tocopherol has been studied in seven control subjects and in twenty-three patients with malabsorption due to various causes. 2. Control subjects absorbed between 55·0 and 78·6% of an oral dose. Radioactivity appeared in the plasma between 1 and 3 hr, reached a peak between 5 and 9 hr, and subsequently fell exponentially with a mean half-life of 53 hr. Radioactivity in plasma was almost all associated with free α-tocopherol. 3. Absorption of α-tocopherol was most severely impaired in patients with biliary obstruction, and somewhat less severely impaired in patients with exocrine pancreatic insufficiency. Malabsorption in patients with an abnormal small intestinal mucosa varied with the severity of the condition, and could be correlated with the degree of steatorrhoea. 4. In two patients with intestinal lymphangiectasia, malabsorption of the vitamin was relatively more severe than that of fat. Mild malabsorption was found in five of the six patients who had had a partial gastrectomy. 5. The amount of radioactivity recovered from the urine in 3 days ranged from 0·0 to 21·4% of the dose given and could be correlated with the degree of absorption.

Role of nonpancreatic lipolytic activity in exocrine pancreatic insufficiency

1987 ◽  
Vol 92 (1) ◽  
pp. 125-129 ◽  
Author(s):  
Cynthia K. Abrams ◽  
Margit Hamosh ◽  
Sudhir K. Dutta ◽  
Van S. Hubbard ◽  
Paul Hamosh
Keyword(s):  
Lipolytic Activity ◽  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Insufficiency

Prevalence and nutritional impact of small intestinal bacterial overgrowth (SIBO) and exocrine pancreatic insufficiency (EPI) in gastrectomized patients

Pancreatology ◽  
2017 ◽  
Vol 17 (3) ◽  
pp. S119-S120
Author(s):  
Ángeles Pérez Aísa ◽  
Leticia Mongil Poce ◽  
Julia Alcaide ◽  
Isabel Méndez Sánchez ◽  
Robin Rivera Irigoin ◽  
...  
Keyword(s):  
Pancreatic Insufficiency ◽  
Bacterial Overgrowth ◽  
Small Intestinal Bacterial Overgrowth ◽  
Exocrine Pancreatic Insufficiency ◽  
Intestinal Bacterial Overgrowth ◽  
Small Intestinal

Exocrine pancreatic insufficiency after esophagectomy: a systematic review of literature

2021 ◽  
Author(s):  
L Blonk ◽  
N J Wierdsma ◽  
E P Jansma ◽  
G Kazemier ◽  
D L van der Peet ◽  
...  
Keyword(s):  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Function ◽  
Exocrine Pancreatic Insufficiency ◽  
Pancreatic Enzymes ◽  
Pancreatic Function ◽  
Study Quality ◽  
Fecal Elastase ◽  
Elastase 1 ◽  
Fecal Fat ◽  
Effect Of Treatment

Summary Complaints of maldigestion, malabsorption, and unintended weight loss after esophagectomy are often attributed to an impaired exocrine pancreatic function. This review systematically summarizes all literature reporting on the presence of exocrine pancreatic insufficiency (EPI) after esophagectomy and the effect of treatment with pancreatic enzymes on gastrointestinal complaints, body weight, and quality of life. Databases of PubMed, Embase, and Wiley/Cochrane Library were searched systematically until July 2020. Studies reporting on EPI and pancreatic enzyme replacement therapy after esophagectomy were included. The Newcastle–Ottawa scale was used to assess study quality. Four studies, including 158 patients, were selected. The maximum score for study quality was six (range 4–6). Exocrine pancreatic function was investigated in three studies, measured by fecal elastase-1 and 72-hour fecal fat excretion. Fecal elastase-1 levels <200 μg/g were reported in 16% of patients at 4 months, 18% at 6 months, and 31% at 18–24 months postoperatively. A decreased fecal fat absorption was noticed in 57% 1 month postoperatively. Treatment with pancreatic enzymes was reported in two studies. In patients with fecal elastase-1 levels <200 μg/g, 90% of patients reported improvement in symptoms and 70% reported improvement in weight. In patients with complaints of steatorrhea, 87% noticed settlement of symptoms. Based on current literature, complaints of maldigestion, malabsorption, and unintended weight loss after esophagectomy are common and can be related to an impaired exocrine pancreatic function. High-quality studies evaluating the presence of EPI and the effect of treatment with pancreatic enzymes after esophagectomy are needed to verify this conclusion.

scholarly journals Nutritional status of patients undergoing pancreatic resection

2022 ◽  
pp. 60-65
Author(s):  
M. V. Malykh ◽  
E. A. Dubtsova ◽  
L. V. Vinokurova ◽  
M. A. Kiryukova ◽  
D. S. Bordin
Keyword(s):  
Quality Of Life ◽  
Nutritional Status ◽  
Pancreatic Resection ◽  
Pancreatic Insufficiency ◽  
Clinical Manifestations ◽  
Exocrine Pancreatic Insufficiency ◽  
Pancreatic Enzymes ◽  
Exocrine Function

Changes in the exocrine function of the pancreas often develops after proximal and distal resections. Exocrine pancreatic insufficiency (EPI) is characterized by a reduced secretion of pancreatic enzymes, because of which the digestion and absorption of nutrients is impaired. Clinical manifestations of EPI and, as a consequence, changes in nutritional status significantly affect the quality of life of patients.

727 EXOCRINE PANCREATIC INSUFFICIENCY AFTER ESOPHAGECTOMY: A SYSTEMATIC REVIEW OF LITERATURE

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Lotte Blonk ◽  
N J Wierdsma ◽  
E P Jansma ◽  
G Kazemier ◽  
D L Peet ◽  
...  
Keyword(s):  
Weight Loss ◽  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Function ◽  
Exocrine Pancreatic Insufficiency ◽  
Pancreatic Enzymes ◽  
Pancreatic Function ◽  
Fecal Elastase ◽  
Elastase 1 ◽  
Fecal Fat ◽  
Effect Of Treatment

Abstract   Complaints of maldigestion, malabsorption, and unintended weight loss after esophagectomy are often attributed to an impaired exocrine pancreatic function. This review systematically summarizes all literature reporting on the presence of exocrine pancreatic insufficiency (EPI) after esophagectomy and the effect of treatment with pancreatic enzymes on gastrointestinal complaints, body weight, and quality of life. Methods Databases of PubMed, Embase, and Wiley/Cochrane Library were searched systematically until July 2020. Studies reporting on EPI and pancreatic enzyme replacement therapy after esophagectomy were included. Results Four studies, including 158 patients, were selected. Exocrine pancreatic function was investigated in three studies, measured by fecal elastase-1 and 72-hour fecal fat excretion. Fecal elastase-1 levels <200 μg/g were reported in 16% of patients at 4 months, 18% at 6 months, and 31% at 18-24 months postoperatively. A decreased fecal fat absorption was noticed in 57% 1 month postoperatively. Treatment with pancreatic enzymes was reported in two studies. In patients with fecal elastase-1 levels <200 μg/g, 90% of patients reported improvement in symptoms and 70% reported improvement in weight. In patients with complaints of steatorrhea, 87% noticed settlement of symptoms. Conclusion Based on current literature, complaints of maldigestion, malabsorption, and unintended weight loss after esophagectomy are common and can be related to an impaired exocrine pancreatic function. High-quality studies evaluating the presence of EPI and the effect of treatment with pancreatic enzymes after esophagectomy are needed to verify this conclusion.

scholarly journals Role of Fibre in Nutritional Management of Pancreatic Diseases

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2219 ◽  
Author(s):  
Emanuela Ribichini ◽  
Serena Stigliano ◽  
Sara Rossi ◽  
Piera Zaccari ◽  
Maria Carlotta Sacchi ◽  
...  
Keyword(s):  
Current Knowledge ◽  
Multiorgan Failure ◽  
Pancreatic Insufficiency ◽  
Pancreatic Enzyme ◽  
Intestinal Barrier ◽  
Fibre Surface ◽  
Exocrine Pancreatic Insufficiency ◽  
Pancreatic Enzymes ◽  
Nutritional Management

The role of fibre intake in the management of patients with pancreatic disease is still controversial. In acute pancreatitis, a prebiotic enriched diet is associated with low rates of pancreatic necrosis infection, hospital stay, systemic inflammatory response syndrome and multiorgan failure. This protective effect seems to be connected with the ability of fibre to stabilise the disturbed intestinal barrier homeostasis and to reduce the infection rate. On the other hand, in patients with exocrine pancreatic insufficiency, a high content fibre diet is associated with an increased wet fecal weight and fecal fat excretion because of the fibre inhibition of pancreatic enzymes. The mechanism by which dietary fibre reduces the pancreatic enzyme activity is still not clear. It seems likely that pancreatic enzymes are absorbed on the fibre surface or entrapped in pectin, a gel-like substance, and are likely inactivated by anti-nutrient compounds present in some foods. The aim of the present review is to highlight the current knowledge on the role of fibre in the nutritional management of patients with pancreatic disorders.

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