scholarly journals Combination of obesity and malnutrition in a patient with chronic alcoholic pancreatitis (case report)

2020 ◽  
Vol 46 (1) ◽  
pp. 43-48
Author(s):  
N. S. Gavrilina ◽  
L. Yu. Ilchenko ◽  
I. G. Fedorov ◽  
I. G. Nikitin
Keyword(s):  
Body Mass Index ◽  
Case Report ◽  
Body Mass ◽  
Pancreatic Insufficiency ◽  
Modern Society ◽  
Exocrine Pancreatic Insufficiency ◽  
Alcoholic Pancreatitis ◽  
Chronic Alcoholic Pancreatitis ◽  
Chronic Alcoholic ◽  
Enzyme Replacement

Eating disorder with its two extreme manifestations — obesity and trophological insufficiency (TI) — is one of the common problems of modern society. TI is often diagnosed in patients with chronic pancreatitis (CP); it occurs due to a limited amount of food intake, malabsorption, diabetes mellitus, and chronic alcoholism. TI severity correlates with severity of malabsorption and depletion of nutrients degree. However, TI verification in patients with CP is difficult due to the lack of uniform diagnostic recommendations. Anthropometric technique, laboratory (determination of the level of lymphocytes, albumin) and instrumental (computed tomography, X-ray absorptiometry, magnetic resonance imaging) diagnostics are usually used. The article presents a case report of combination of such two opposite states as obesity and malnutrition in a patient with CP. The patient was hospitalized with CP exacerbation and alcohol abuse. Examination revealed exocrine pancreatic insufficiency and mild malnutrition. Enzyme replacement therapy and additional oral sip feeding with a positive effect were prescribed. Exocrine pancreatic insufficiency stopped after 10 weeks of treatment, but malnutrition remained and required a longer course of treatment. Relevance of this problem, main difficulties of diagnosis are presented in the article. Anthropometric indices, body mass index, lymphocytes, total protein, albumin need to be measured in all patients. Using only body mass index leads to hypodiagnosis of malnutrition in patients with CP.

scholarly journals COMBINATION OF O BESITY AND MALNUTRITION AT A PATIENT WITH CHRONIC ALCOHOLIC PANCREATITIS (CASE REPORT)

2018 ◽  
Vol 8 (6) ◽  
pp. 475-479 ◽  
Author(s):  
N. S. Gavrilina ◽  
L. Yu. Ilchenko ◽  
I. G. Fedorov ◽  
I. G. Nikitin
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Insufficiency ◽  
Alcoholic Pancreatitis ◽  
Anthropometric Parameters ◽  
Chronic Alcoholic Pancreatitis ◽  
Chronic Alcoholic ◽  
Enzyme Replacement ◽  
Clinical Description ◽  
Positive Effect

The article contains a clinical description of the case of combination of such two opposite states as obesity and malnutrition in a patient with chronic pancreatitis. The patient was hospitalized with exacerbation of chronic pancreatitis and alcohol abuse. The examination revealed exocrine pancreatic insufficiency and mild malnutrition. The patient was prescribed enzyme replacement therapy and additional oral sip feeding with a positive effect. After 10 weeks of exocrine pancreatic insufficiency were stopped, but malnutrition remained and required a longer course of treatment. The relevance of this problem, the main difficulties of diagnosis were presented in the article. All patients need to measure anthropometric parameters, BMI, lymphocytes, total protein, albumin. Using only BMI leads to hypodiagnosis of malnutrition in patients with chronic pancreatitis.

scholarly journals СORRECTION OF MALNUTRITION IN PATIENTS WITH CHRONIC PANCREATITIS

2019 ◽  
Vol 9 (1) ◽  
pp. 70-80 ◽  
Author(s):  
N. S. Gavrilina ◽  
L. Yu. Ilchenko ◽  
G. A. Sedova ◽  
I. G. Fedorov ◽  
I. G. Nikitin
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Insufficiency ◽  
Pancreatic Enzyme ◽  
Alcoholic Pancreatitis ◽  
Chronic Obstructive ◽  
High Dose ◽  
Chronic Alcoholic Pancreatitis ◽  
Chronic Alcoholic ◽  
Enzyme Replacement ◽  
Group I

Aim:To estimate the frequency of occurrence malnutrition and efficacy its correction in chronic pancreatitis (CP).Materials and methods:148 patients were examined. Group I included 71 people with chronic alcoholic pancreatitis (CAP); group II — 77 patients with chronic obstructive pancreatitis (COP). Trophological status (TS) was investigated by criteria of V.M. Luft. Lymphocytes, pancreatic amylase, lipase, total protein, albumin, urine diastase and faecal elastase-1 were investigated before and after treatment. Two treatment options were used: combination therapy (CT, (Mezym-forte 10500 USP/day and pharmaconutrient Ensure 2 200 ml/day)) and high-dose pancreatic enzyme replacement therapy ((HD PERT), Kreon 120000 USP/day) for 10 weeks. 62 patients received HD PERT: 24 patients with CAP and 38 patients with COP; CT — 86 patients: 47 and 39, respectively.Results:The prevalence of malnutrition in patients with CP was 92% (n=136). Lymphopenia was determined in 44%, hypoproteinemia-in 11,5%, hypoalbuminemia-in 54%. 12 (8%) patients did not have malnutrition. In the group CAP: mild malnutrion was established in44, moderate — in 20, severe — 2, eutrophia — 6; in the group COP: mild malnutrion — in 33, moderate — in 37, severe — 0, eutrophia — 6. Aftertreatment in the group CAP: malnutrion moderate — in 7, mild — 58, eutrophia — 7, in the COP: malnutrion moderate — 37, mind — 31, eutrophy — 8.Conclusions:Malnutrition is frequent symptom complex in patients with CP. The severity of malnutrition is more severy in CAP. The most effective treatment malnutrition was CT in patients with CAP. HD PERT is indicated to correct exocrine pancreatic insufficiency.

scholarly journals Nutritional profile of asymptomatic alcoholic patients

2011 ◽  
Vol 48 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Maria Beatriz Sobral-Oliveira ◽  
Joel Faintuch ◽  
Dulce Reis Guarita ◽  
Claudia P. Oliveira ◽  
Flair J. Carrilho
Keyword(s):  
Lean Body Mass ◽  
Body Mass ◽  
Alcoholic Pancreatitis ◽  
C Reactive Protein ◽  
Chronic Alcoholic Pancreatitis ◽  
Chronic Alcoholic ◽  
Vitamin Deficiencies ◽  
Reactive Protein ◽  
Amyloid A ◽  
Visceral Disease

CONTEXT: Alcoholism may interfere with nutritional status, but reports are often troubled by uncertainties about ingested diet and organ function, as well as by ongoing abuse and associated conditions. OBJECTIVE: To identify nutritional and body compartment changes in stable alcoholics without confounding clinical and dietetic variables, a prospective observational pilot study was designed. Three well-matched populations were considered: subjects with chronic alcoholic pancreatitis, alcoholics without visceral disease, and healthy never-drinking adults (controls). METHODS: Subjects (n = 60) were asymptomatic males with adequate diet, no superimposed disease or complication, and alcohol-free for at least 6 months. After exclusions, 48 patients were compared. Variables encompassed dietary recall, bioimpedance analysis, biochemical profile and inflammatory markers. Main outcome measures were body fat, lean body mass, serum lipids, C-reactive protein, and selected minerals and vitamins. RESULTS: Both alcoholic populations suffered from reduced lean body mass (P = 0.001), with well-maintained body fat.Magnesium was depleted, and values of vitamin D and B12 correlated with alcohol abuse. LDL and total cholesterol was increased in alcoholics without pancreatitis (P = 0.04), but not in those with visceral damage. C-reactive protein and serum amyloid A correlated with duration of excessive drinking (P = 0.01). CONCLUSIONS: Undernutrition (diminished lean body mass, risk of magnesium and vitamin deficiencies) contrasted with dyslipidemia and increased cardiovascular risk. This second danger was masked during chronic pancreatitis but not in alcoholics without visceral disease. Further studies should focus special requirements of this population.

CASE REPORT: Chronic Alcoholic Pancreatitis with Pancreas Divisum

2004 ◽  
Vol 49 (6) ◽  
pp. 992-996
Author(s):  
Tsuneo Tanaka ◽  
Yasuhiro Matsugu ◽  
Tatsuyoshi Fujii ◽  
Tatsuroh Ishimoto ◽  
Naoki Kagawa ◽  
...  
Keyword(s):  
Case Report ◽  
Pancreas Divisum ◽  
Alcoholic Pancreatitis ◽  
Chronic Alcoholic Pancreatitis ◽  
Chronic Alcoholic ◽  
Pancréas Divisum

scholarly journals Experience of using specialized mixture of enteral nutrition in children with nutritive deficiency in cystic fibrosis

2019 ◽  
Vol 2 (21) ◽  
pp. 47-52
Author(s):  
E. I. Kondratieva ◽  
T. Yu. Maksimycheva ◽  
A. Yu. Voronkova ◽  
V. D. Sherman
Keyword(s):  
Body Mass Index ◽  
Cystic Fibrosis ◽  
Enteral Nutrition ◽  
Body Mass ◽  
Pancreatic Insufficiency ◽  
Protein Energy Malnutrition ◽  
Exocrine Pancreatic Insufficiency ◽  
The Body ◽  
Multisystem Disease ◽  
Protein Energy

Сystic fibrosis is an autosomal recessive hereditary multisystem disease which is characterized by severe exocrine pancreatic insufficiency, chronic lung disease, and protein-energy malnutrition. Some studies have indicated that the body mass index is an independent factor which adversely affected survival of patients with cystic fibrosis. There is a direct correlation between body mass index, lung function and life expectancy. Objective. To determine the effectiveness and tolerability of the product for children’s dietary nutrition ‘NUTRINIdrink with dietary fibre (neutral taste)’ for children over one year of age for enteral nutrition in cystic fibrosis complicated by protein-energy deficiency.

scholarly journals Digestive enzyme replacement relieves growth failure in preterm infants with poor exocrine pancreatic function: a retrospective case series

2021 ◽  
Author(s):  
Annette Münch ◽  
Christoph Bührer ◽  
Ann Carolin Longardt
Keyword(s):  
Weight Gain ◽  
Preterm Infants ◽  
Digestive Enzyme ◽  
Pancreatic Insufficiency ◽  
Growth Failure ◽  
Exocrine Pancreatic Function ◽  
Exocrine Pancreatic Insufficiency ◽  
Very Preterm Infants ◽  
Enzyme Replacement ◽  
Fecal Pancreatic Elastase

AbstractIn orally fed preterm infants, poor weight gain may be linked to low fecal pancreatic elastase-1 (FPE-1) activity, indicative of exocrine pancreatic insufficiency. The objective of this study was the retrospective assessment of the effect of exogenous digestive enzyme replacement by gavage in preterm infants with growth failure and low FPE-1 (<200 μg/g). We analyzed weight gain relative to baseline and caloric intake during 14-day periods before and after institution of digestive enzyme replacement containing 6000 U lipase and 240 U protease kg−1 d−1. Among 46 of 132 preterm infants < 1250g birth weight surviving to at least 14 days in whom FPE-1 was determined, 38 infants had low FPE-1 (< 200 μg/g), and 33 infants received exogenous digestive enzyme replacement. Average daily weight gain significantly increased from 14.4 [range 2.6–22.4] g kg−1 d−1 to 17.4 [8.4–29.0] g kg−1 d−1 (P = 0.001), as did weight gain per kcal, from 0.08 [0.02–0.13] g kcal−1 d−1 to 0.11 [0.05–0.18] g kcal−1 d−1.Conclusion: In preterm infants with signs and symptoms of exocrine pancreatic insufficiency, exogenous digestive enzyme replacement is associated with improved growth. What is Known:• Very preterm infants on full enteral nutrition may display growth failure linked to transient poor exocrine pancreatic function.• Porcine pancreatic enzymes covered with an acid-resistant coating are too large to pass the internal diameter of most gavage tubes used in very preterm infants.What is New:• Administration of a liquid formulation of acid-resistant microbial digestive enzymes in preterm infants with growth failure and low fecal pancreatic elastase-1 values was associated with improved weight gain.• Response to exogenous digestive enzyme replacement was associated with the prior extent of growth failure.

scholarly journals A case of splenic artery pseudoaneurysm rupture presenting as rectal bleeding in a regional hospital

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Jonathon N Holt ◽  
Heinrich E Schwalb
Keyword(s):  
Rectal Bleeding ◽  
Splenic Artery ◽  
Artery Aneurysm ◽  
Regional Hospital ◽  
Alcoholic Pancreatitis ◽  
Chronic Alcoholic Pancreatitis ◽  
Chronic Alcoholic ◽  
Artery Pseudoaneurysm ◽  
Previous Trauma ◽  
Splenic Artery Pseudoaneurysm

Abstract Splenic artery pseudoaneurysm is a rare phenomenon most associated with chronic pancreatitis or previous trauma. Complications can include erosion and rupture into local structures, a situation that carries a reported mortality of 10–40%. A 58-year-old male with chronic alcoholic pancreatitis and a known splenic artery pseudoaneurysm presented to the emergency department of a regional hospital with rectal bleeding and sepsis. Computed tomography revealed a peri-splenic mass communicating with the splenic flexure. The patient was taken for an emergency splenectomy and left hemicolectomy and was confirmed to have rupture of the splenic artery aneurysm into the large bowel. This case presented with comparable features reported in the literature and demonstrates that access to emergency specialist surgical services in a regional setting offers the capability to manage rare, life threatening surgical emergencies.

scholarly journals Efficacy and Safety of a New Formulation of Pancrelipase (Ultrase MT20) in the Treatment of Malabsorption in Exocrine Pancreatic Insufficiency in Cystic Fibrosis

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Michael W. Konstan ◽  
Theodore G. Liou ◽  
Steven D. Strausbaugh ◽  
Richard Ahrens ◽  
Jamshed F. Kanga ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pancreatic Insufficiency ◽  
Pancreatic Enzyme ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Exocrine Pancreatic Insufficiency ◽  
Efficacy And Safety ◽  
Protein Nitrogen ◽  
Enzyme Replacement ◽  
New Formulation

Background. Pancreatic enzyme replacement therapy is the standard of care for treatment of malabsorption in patients with cystic fibrosis (CF) and exocrine pancreatic insufficiency (PI).Aim. To evaluate efficacy and safety of a new formulation of pancrelipase (Ultrase MT20) in patients with CF and PI. Coefficients of fat absorption (CFA%) and nitrogen absorption (CNA%) were the main efficacy parameters. Safety was evaluated by monitoring laboratory analyses, adverse events (AEs), and overall signs and symptoms.Methods. Patients (n=31) were randomized in a crossover design comparing this pancrelipase with placebo during 2 inpatient evaluation periods (6-7 days each). Fat and protein/nitrogen ingestion and excretion were measured from food diaries and 72-hour stool collections. CFA% and CNA% were calculated for each period and compared.Results. Twenty-four patients provided analyzable data. This pancrelipase increased mean CFA% and CNA% (+34.7% and +25.7%, resp.,P<.0001for both), reduced stool frequency, and improved stool consistency compared with placebo. Placebo-treated patients reported more AEs, with gastrointestinal symptoms being the most frequently reported AE.Conclusions. This pancrelipase is a safe and effective treatment for malabsorption associated with exocrine PI in patients with CF.

Novel ciliate lipases for enzyme replacement during exocrine pancreatic insufficiency

2016 ◽  
Vol 28 (11) ◽  
pp. 1305-1312 ◽  
Author(s):  
Alexander Brock ◽  
Ingo Aldag ◽  
Stella Edskes ◽  
Marcus Hartmann ◽  
Torsten Herzog ◽  
...  
Keyword(s):  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Insufficiency ◽  
Enzyme Replacement
Sign in / Sign up

Export Citation Format

Share Document