Enzyme insufficiency of the pancreas limited secretion or low activity of pancreatic enzymes, leading to disruption in the cleavage and absorption of nutrients in the intestine. Diagnosis is based on laboratory methods of examining the external secretion of the pancreas, carrying out a coprogram, determining the level of enzymes in the feces. Treatment includes therapy of the underlying disease, normalization of nutrient intake, substitution of pancreatic enzymes, symptomatic treatment.
Enzyme insufficiency of the pancreas is one of the varieties of food intolerance that develops against the backdrop of oppression of exocrine pancreatic activity. It is not possible to evaluate the frequency of exocrine pancreatic insufficiency in the population, since studies devoted to this condition are practically not conducted, and the frequency of detection of enzyme deficiency is much higher than, for example, chronic pancreatitis. Nevertheless, inadequate production of pancreatic enzymes is a serious condition that can lead to severe depletion and even death of the patient in the absence of adequate treatment.
In the clinical picture of pancreatic enzyme deficiency, the most important is the syndrome of maldigestia (oppression of digestion in the lumen of the intestine). Undigested fats, getting into the lumen of the large intestine, stimulate the secretion of the colonocytes, polyphecal and diarrhea is formed (the stool is liquid, enlarged in volume), the stool has a fetid smell, the color is gray, the surface is oily, shiny.
Treatment of exocrine pancreatic insufficiency should be complex, including correction of nutritional status, etiotropic and substitution therapy, symptomatic treatment. Etiotropic therapy is aimed mainly at preventing the progression of the death of the parenchyma of the prostate. Correction of eating behavior is to exclude the use of alcohol and tobacco, increase the amount of protein in the diet to 150g / day, reduce the amount of fat at least twice the physiological norm, the intake of vitamins in therapeutic dosages. With severe depletion, partial or complete parenteral nutrition may be required.