Exocrine pancreas insufficiency: clinical significance and approaches to correction from evidence medicine
- Authors: Maev I.V.1, Kucheryavyy Y.A.2, Andreev D.N.1
-
Affiliations:
- Yevdokimov Moscow State University of Medicine and Dentistry
- Ilyinskaya Hospital
- Issue: Vol 93, No 4 (2021)
- Pages: 509-515
- Section: Reviews
- URL: https://journals.rcsi.science/0040-3660/article/view/71269
- DOI: https://doi.org/10.26442/00403660.2021.04.200800
- ID: 71269
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Abstract
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.
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##article.viewOnOriginalSite##About the authors
Igor V. Maev
Yevdokimov Moscow State University of Medicine and Dentistry
Email: dna-mit8@mail.ru
ORCID iD: 0000-0001-6114-564X
акад. РАН, д.м.н., проф., зав. каф. пропедевтики внутренних болезней и гастроэнтерологии ФГБОУ ВО «МГМСУ им. А.И. Евдокимова», засл. врач РФ, засл. деят. науки РФ
Russian Federation, MoscowYury A. Kucheryavyy
Ilyinskaya Hospital
Email: dna-mit8@mail.ru
ORCID iD: 0000-0001-7760-2091
к.м.н., доц., зав. гастроэнтерологическим отд-нием
Russian Federation, Krasnogorsk, village GlukhovoDmitry N. Andreev
Yevdokimov Moscow State University of Medicine and Dentistry
Author for correspondence.
Email: dna-mit8@mail.ru
ORCID iD: 0000-0002-4007-7112
к.м.н., доц. каф. пропедевтики внутренних болезней и гастроэнтерологии
Russian Federation, MoscowReferences
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