Pancreatic Insufficiency
Pancreatic insufficiency occurs when the pancreas does not secrete enough chemicals and digestive enzymes for normal digestion to occur. When pancreatic insufficiency is severe, malabsorption (impaired absorption of nutrients by the intestines) may result, leading to deficiencies of essential nutrients and the occurrence of loose stools containing unabsorbed fat (steatorrhea).
Severe pancreatic insufficiency occurs in cystic fibrosis, chronic pancreatitis, and surgeries of the gastrointestinal system in which portions of the stomach or pancreas are removed. Certain gastrointestinal diseases, such as stomach ulcers, celiac disease, and Crohn’s disease, and autoimmune disorders, such as systemic lupus erythematosus (SLE), may contribute to the development of pancreatic insufficiency. Mild forms of pancreatic insufficiency are often difficult to diagnose, and there is controversy among researchers regarding whether milder forms of pancreatic insufficiency need treatment.
Pancreatitis is an inflammation of the pancreas that reduces the function of the pancreas, causing pancreatic insufficiency, malabsorption, and diabetes. Acute pancreatitis is usually a temporary condition and can be caused by gallstones, excessive alcohol consumption, high blood triglycerides, abdominal injury, and other diseases, and by certain medications and poisons. Chronic pancreatitis is a slow, silent process that gradually destroys the pancreas and is most often caused by excessive alcohol consumption.
What are the symptoms of pancreatic insufficiency?
People with pancreatic insufficiency may have symptoms of pale, foul-smelling, bulky stools that stick to the side of the toilet bowl or are difficult to flush, oil droplets floating in the toilet bowl after bowel movements, and abdominal discomfort, gas, and bloating. People with pancreatic insufficiency may also have bone pain, muscle cramps, night blindness, and easy bruising.
How is it treated?
The conventional treatment includes taking pancreatic enzymes with meals. In advanced cases, doctors may also recommend intravenous nutritional supplements of the fat-soluble vitamins (e.g., vitamins A, D, E, K).
Dietary changes that may be helpful:
A low-fat diet (with no more than 30 to 40% of calories from fat) is often recommended to help prevent the steatorrhea that often accompanies pancreatic insufficiency. In a controlled study of chronic pancreatitis patients, a very low-fat diet resulted in less than one-fourth as much steatorrhea compared to a more typical fat intake. Since a very low-fat diet may not be appropriate for a person with malnutrition, this recommendation should only be followed after consulting a healthcare professional.
Lifestyle changes that may be helpful:
Since alcoholism is one known cause of pancreatitis, total abstinence from alcohol is generally recommended to people with this disease.
Cigarette smoking decreases pancreatic secretion and increases the risk of pancreatitis and pancreatic cancer, providing yet another reason to quit smoking.
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