Open AccessExocrine pancreas insufficiency: clinical significance and approaches to correction from evidence medicine
Author(s) -
И. В. Маев,
Маев Игорь Вениаминович,
Yu.A. Kucheryavy,
Кучерявый Юрий Александрович,
D. N. Andreev,
Андреев Дмитрий Николаевич
Publication year - 2021
Publication title -
terapevtičeskij arhiv
Language(s) - English
Resource type - Journals
eISSN - 2309-5342
pISSN - 0040-3660
DOI - 10.26442/00403660.2021.04.200800
Subject(s) - pancreatitis , malabsorption , medicine , exocrine pancreatic insufficiency , malnutrition , pancreas , complication , cystic fibrosis , population , pancreatic cancer , disease , pancreatic disease , acute pancreatitis , clinical significance , intensive care medicine , osteoporosis , gastroenterology , cancer , environmental health
Exocrine pancreatic insufficiency (EPI) is a common complication of both benign and malignant diseases of the pancreas, as well as a consequence of radical surgical operations on the pancreas and a whole range of other variable extra-pancreatic causes. In clinical practice in the adult population, most cases of EPI are associated with chronic pancreatitis, while in the pediatric population with cystic fibrosis. The regression of the production of digestive enzymes in EPI mediates the development of the syndrome of maldigestion and malabsorption, leading to the progressive development of malnutrition, the importance of which is often underestimated by practitioners. At the same time, the development of nutritional deficiency is not just a complication of EPI, but also has an important effect on the course of the underlying causative disease, worsening the prognosis and quality of life of the patient, and is also a proven risk factor for osteoporosis and sarcopenia. To date, compensation for the absolute deficiency of pancreatic enzymes using enzyme replacement therapy is the only possible way to correct the EPI and prevent nutritional deficiency.