The role of minor pancreatic exocrine deficiency in digestive disorders: a review
Dreiling, D.A.
American Journal of Gastroenterology 78(11): 732-735
1983
ISSN/ISBN: 0002-9270 PMID: 6637964 Document Number: 203905
Evidence is presented which indicates that, in illnesses, functional pancreatic deficiency may be the cause of or contribute to observed digestive complaints. The pancreatic functional deficiency may derive from changes in gut pathway or motility, from metabolic or endocrinological changes, from extrapancreatic pathology, or may be the result of subclinical pancreatic pathology itself. It is concluded that implications are, whether or not digestive complaints, particularly diarrhoea and steatorrhoea, can be explained on the basis of existing extrapancreatic disease, the failure of those symptoms to respond to standard treatment or their presence in extraordinary severity suggest the possibility of functional or minor pancreatic deficiency. Investigation of such possibility cannot be accomplished by screening tests, digestive tolerance tests (Lundh, PABA) or stool examination but requires direct study of exocrine pancreatic secretion in response to standard stimuli. In diagnosis of minor pancreatic dysfunction, it is important to recognize pancreatic hypersecretion as the initial abnormality. In patients in whom pancreatic dysfunction is detected, treatment with diet and pancreatic extract of proved potency will result in clinical improvement.