Document Detail


Chronic pancreatitis: maldigestion, intestinal ecology and intestinal inflammation.
MedLine Citation:
PMID:  19360910     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Exocrine pancreatic insufficiency caused by chronic pancreatitis results from various factors which regulate digestion and absorption of nutrients. Pancreatic function has been extensively studied over the last 40 years, even if some aspects of secretion and gastrointestinal adaptation are not completely understood. The main clinical manifestations of exocrine pancreatic insufficiency are fat malabsorption, known as steatorrhea, which consists of fecal excretion of more than 6 g of fat per day, weight loss, abdominal discomfort and abdominal swelling sensation. Fat malabsorption also results in a deficit of fat-soluble vitamins (A, D, E and K) with consequent clinical manifestations. The relationships between pancreatic maldigestion, intestinal ecology and intestinal inflammation have not received particular attention, even if in clinical practice these mechanisms may be responsible for the low efficacy of pancreatic extracts in abolishing steatorrhea in some patients. The best treatments for pancreatic maldigestion should be re-evaluated, taking into account not only the correction of pancreatic insufficiency using pancreatic extracts and the best duodenal pH to permit optimal efficacy of these extracts, but we also need to consider other therapeutic approaches including the decontamination of intestinal lumen, supplementation of bile acids and, probably, the use of probiotics which may attenuate intestinal inflammation in chronic pancreatitis patients.
Authors:
Raffaele Pezzilli
Publication Detail:
Type:  Editorial; Review    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  15     ISSN:  1007-9327     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-10     Completed Date:  2009-05-19     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  1673-6     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Exocrine Pancreatic Insufficiency / diagnosis,  drug therapy,  physiopathology*
Humans
Inflammation / pathology,  physiopathology*
Intestines* / microbiology,  physiopathology
Pancreatic Extracts / therapeutic use
Pancreatitis / diagnosis,  drug therapy,  physiopathology*
Chemical
Reg. No./Substance:
0/Pancreatic Extracts
Comments/Corrections

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