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Pancreatic Enzyme Syndromes

The pancreas is found deep in the abdomen, behind the stomach, spleen, and colon. The pear-shaped organ has two main functions-producing insulin and producing enzymes that are crucial to food digestion. Pancreatic enzymes break down certain nutrients into small segments that can be absorbed by the bloodstream from the intestinal tract. Insufficient production of these enzymes does not allow the body to process food correctly.

  1. Enzyme Types

    • The three main enzymes produced by the pancreas are amalyse, which aids in the digestion of carbohydrates; trypsin, which helps digest proteins, and lipase, which helps to digest fats. For healthy digestion, the pancreas has to manufacture the right amount of enzymes after the food enters the duodenum, the area of the small intestine just past the stomach.

    Causes

    • Pancreatic enzyme insufficiency is caused by injury to the pancreas, diseases that damage digestive enzyme-producing cells or conditions that cause blockage of the pancreatic ducts. The most common causes are cystic fibrosis, celiac disease and chronic pancreatitis. Enzyme deficiency may also occur because of a pancreatic tumor or after pancreatic surgery.

    Symptoms

    • Diminished pancreatic enzyme function may seriously affect overall digestion. Undigested food in the intestine results in chronic diarrhea and loose, oily stools that are hard to flush. Nausea, vomiting, abdominal pain and cramping are common, and poor food absorption results in malnutrition, weight loss, and vitamin deficiencies.

    Diagnosis

    • When pancreatic insufficiency is suspected, a fecal fat test will be performed. The test measures the level of fat in the stool, and determines how much fat the body is not processing. Your doctor may also order magnetic resonance imaging (MRI) to look for any changes in the bile ducts or pancreas. Another option is Endoscopic retrograde cholangiopancreatography (ERCP); a scope is inserted into the pancreas via the nose and the pancreas is visually inspected for damage.

    Treatment

    • Treatment for pancreatic enzyme deficiency is aimed at managing the symptoms, and, if applicable, treating the underlying disease or condition that caused the problem. Following a low-fat, low-calorie, high-protein diet is recommended. Digestive enzymes, which help the body process and absorb food, should be taken with every meal, and fat-soluble vitamin supplements are often recommended as well.

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