Pancreatic insufficiency: Difference between revisions
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{{SI}} | {{SI}} | ||
{{CMG}}; {{AE}} {{VSKP}} | {{CMG}}; {{AE}} {{VSKP}} | ||
{{SK}} Exocrine pancreatic insufficiency | |||
== Overview == | == Overview == | ||
Pancreatic insufficiency is characterized by deficiency of the exocrine [[pancreatic enzymes]], resulting in the inability to digest food properly, or maldigestion. | Pancreatic insufficiency is characterized by deficiency of the exocrine [[pancreatic juice|pancreatic enzymes]], resulting in the inability to digest food properly, or maldigestion. | ||
== Causes == | == Causes == | ||
===Common | ===Common Causes=== | ||
*[[Chronic alcoholism]] | *[[Chronic alcoholism]] | ||
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*[[Gastrectomy]] | *[[Gastrectomy]] | ||
*[[Shwachman-Diamond syndrome]] | *[[Shwachman-Diamond syndrome]] | ||
*[[Zollinger-Ellison syndrome]] | |||
===Causes by Organ System=== | ===Causes by Organ System=== | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Gastroenterologic''' | | '''Gastroenterologic''' | ||
|bgcolor="Beige"| [[Chronic pancreatitis]], [[Cystic fibrosis]], [[Diabetic gastroparesis]], [[Gallstones]], [[Hemochromatosis]] | |bgcolor="Beige"| [[Bowel resection]], [[Celiac disease]], [[Chronic pancreatitis]], [[Cystic fibrosis]], [[Diabetic gastroparesis]], [[Gallstones]], [[Hemochromatosis]] , [[Short bowel syndrome]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Genetic''' | | '''Genetic''' | ||
|bgcolor="Beige"| [[Alpha 1-antitrypsin deficiency]], [[Annular pancreas]], [[Ataxia telangiectasia]], [[Congenital lipomatosis of pancreas]], [[Congenital pancreatic dysfunction]], [[Congenital partial lipodystrophy]], [[Cystic fibrosis]], [[Havlikova syndrome]], [[Hemochromatosis]], [[Hereditary pancreatitis]], [[Homocystinuria]], [[Johanson- | |bgcolor="Beige"| [[Alpha 1-antitrypsin deficiency]], [[Annular pancreas]], [[Ataxia telangiectasia]], [[Congenital lipomatosis of pancreas]], [[Congenital pancreatic dysfunction]], [[Congenital partial lipodystrophy]], [[Cystic fibrosis]], [[Havlikova syndrome]], [[Hemochromatosis]], [[Hereditary pancreatitis]], [[Homocystinuria]], [[Johanson-Blizzard syndrome]], [[Juvenile tropical pancreatitis syndrome]], [[Pancreatic agenesis]], [[Pearson syndrome]], [[Shwachman-Diamond syndrome]], [[Situs inversus totalis with cystic dysplasia of pancreas]], [[Wolfram's disease]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Iatrogenic''' | | '''Iatrogenic''' | ||
|bgcolor="Beige"| [[ | |bgcolor="Beige"| [[Bowel resection]], [[Gastrectomy]] , [[Pancreatectomy]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Nutritional/Metabolic''' | | '''Nutritional/Metabolic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Malnutrition]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Rheumatology/Immunology/Allergy''' | | '''Rheumatology/Immunology/Allergy''' | ||
|bgcolor="Beige"| [[Autoimmune lymphoproliferative syndrome]], [[Lupus]], [[Polyglandular autoimmune syndrome]], [[Sjogren's syndrome]] | |bgcolor="Beige"| [[Autoimmune lymphoproliferative syndrome]], [[Lupus]], [[Polyglandular autoimmune syndrome]], [[Sjogren's syndrome]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Miscellaneous''' | | '''Miscellaneous''' | ||
|bgcolor="Beige"| [[Chronic alcoholism]], [[Pancreatic cyst]], [[Pancreatic duct]] | |bgcolor="Beige"| [[Chronic alcoholism]], [[Pancreatic cyst]], [[Cholestasis|Pancreatic duct obstruction]], [[Pancreatic pseudocyst]] | ||
|- | |- | ||
|} | |} | ||
===Causes in Alphabetical Order=== | ===Causes in Alphabetical Order=== | ||
{{columns-list | {{columns-list| | ||
*[[Acute intermittent porphyria]] | *[[Acute intermittent porphyria]] | ||
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*[[Ataxia telangiectasia]] | *[[Ataxia telangiectasia]] | ||
*[[Autoimmune lymphoproliferative syndrome]] | *[[Autoimmune lymphoproliferative syndrome]] | ||
*[[Bowel resection]] | |||
*[[Celiac disease]] | |||
*[[Chronic alcoholism]] | *[[Chronic alcoholism]] | ||
*[[Chronic pancreatitis]] | *[[Chronic pancreatitis]] | ||
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*[[Diabetic gastroparesis]] | *[[Diabetic gastroparesis]] | ||
*[[Gallstones]] | *[[Gallstones]] | ||
*[[Gastrectomy]] | |||
*[[Gestational diabetes]] | *[[Gestational diabetes]] | ||
*[[Havlikova syndrome]] | *[[Havlikova syndrome]] | ||
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*[[Hypertriglyceridemia]] | *[[Hypertriglyceridemia]] | ||
*[[Idiopathic pancreatitis]] | *[[Idiopathic pancreatitis]] | ||
*[[Johanson- | *[[Johanson-Blizzard syndrome]] | ||
*[[Juvenile tropical pancreatitis syndrome]] | *[[Juvenile tropical pancreatitis syndrome]] | ||
*[[Lupus]] | *[[Lupus]] | ||
*[[Malnutrition]] | |||
*[[Mumps]] | *[[Mumps]] | ||
*[[Pancreatectomy]] | *[[Pancreatectomy]] | ||
* [[Pancreas divisum]] | |||
*[[Pancreatic agenesis]] | *[[Pancreatic agenesis]] | ||
*[[Pancreatic cancer]] | *[[Pancreatic cancer]] | ||
*[[Pancreatic cyst]] | *[[Pancreatic cyst]] | ||
*[[Pancreatic duct]] | *[[Cholestasis|Pancreatic duct obstruction]] | ||
*[[Pancreatic pseudocyst]] | *[[Pancreatic pseudocyst]] | ||
*[[Pearson syndrome]] | *[[Pearson syndrome]] | ||
*[[Polyglandular autoimmune syndrome]] | *[[Polyglandular autoimmune syndrome]] | ||
*[[Short bowel syndrome]] | |||
*[[Shwachman-Diamond syndrome]] | *[[Shwachman-Diamond syndrome]] | ||
*[[Situs inversus totalis with cystic dysplasia of pancreas]] | *[[Situs inversus totalis with cystic dysplasia of pancreas]] | ||
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== Diagnosis == | == Diagnosis == | ||
=== History and Symptoms === | === History and Symptoms === | ||
*[[Fatty stools]] | *[[Fatty stools]] | ||
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== Differential Diagnosis of Causes of {{PAGENAME}}== | == Differential Diagnosis of Causes of {{PAGENAME}}== | ||
{{columns-list| | {{columns-list| | ||
*[[Chronic alcoholism]] | *[[Chronic alcoholism]] | ||
*[[Congenital pancreatic dysfunction]] | *[[Congenital pancreatic dysfunction]] | ||
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*[[Zollinger-Ellison syndrome]] | *[[Zollinger-Ellison syndrome]] | ||
}} | }} | ||
==Treatment== | |||
Often pancreatic insufficiency is treated with Pancreatic Enzyme Products (PEPs), such as [[pancrelipase]], that are used to breakdown fats ([[lipases]]), proteins ([[proteases]]) and carbohydrates ([[amylases]]) into units that can be digested by those with pancreatic insufficiency. <ref>[http://www.fda.gov/cder/otcmonographs/category_sort/pancreatic_insufficiency.htm FDA rulemaking history of OTC EPI drug products]</ref> | |||
== References == | == References == | ||
{{Reflist}} | {{Reflist}} | ||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
Latest revision as of 22:18, 10 January 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]
Synonyms and keywords: Exocrine pancreatic insufficiency
Overview
Pancreatic insufficiency is characterized by deficiency of the exocrine pancreatic enzymes, resulting in the inability to digest food properly, or maldigestion.
Causes
Common Causes
- Chronic alcoholism
- Chronic pancreatitis
- Cystic fibrosis
- Gall stones
- Gastrectomy
- Shwachman-Diamond syndrome
- Zollinger-Ellison syndrome
Causes by Organ System
Causes in Alphabetical Order
- Acute intermittent porphyria
- Alagille syndrome
- Alpha-1 antitrypsin deficiency
- Annular pancreas
- Ataxia telangiectasia
- Autoimmune lymphoproliferative syndrome
- Bowel resection
- Celiac disease
- Chronic alcoholism
- Chronic pancreatitis
- Congenital lipomatosis of pancreas
- Congenital pancreatic dysfunction
- Congenital partial lipodystrophy
- Cystic fibrosis
- Diabetic gastroparesis
- Gallstones
- Gastrectomy
- Gestational diabetes
- Havlikova syndrome
- Hemochromatosis
- Hereditary pancreatitis
- Homocystinuria
- Hyperparathyroidism
- Hypertriglyceridemia
- Idiopathic pancreatitis
- Johanson-Blizzard syndrome
- Juvenile tropical pancreatitis syndrome
- Lupus
- Malnutrition
- Mumps
- Pancreatectomy
- Pancreas divisum
- Pancreatic agenesis
- Pancreatic cancer
- Pancreatic cyst
- Pancreatic duct obstruction
- Pancreatic pseudocyst
- Pearson syndrome
- Polyglandular autoimmune syndrome
- Short bowel syndrome
- Shwachman-Diamond syndrome
- Situs inversus totalis with cystic dysplasia of pancreas
- Sjogren's syndrome
- Trauma
- Wolfram's disease
- Zollinger-Ellison syndrome
Diagnosis
History and Symptoms
Differential Diagnosis of Causes of Pancreatic insufficiency
Treatment
Often pancreatic insufficiency is treated with Pancreatic Enzyme Products (PEPs), such as pancrelipase, that are used to breakdown fats (lipases), proteins (proteases) and carbohydrates (amylases) into units that can be digested by those with pancreatic insufficiency. [1]
References