Hôpital Beaujon, Service de gastroentérologie-pancréatologie, 92118 Clichy cedex
The description of fatty diarrhea in the context of chronic pancreatitis or following pancreatic surgery evokes the diagnosis of pancreatic exocrine insufficiency (PEI). But symptoms may be less typical (flatulence, weight loss) and the origin of diarrhea can be complex and multifactorial. It is very important to confirm PEI, by dosing the fecal elastase on a stool sample. PEI can have major nutritional consequences, leading to malnutrition, especially in patients with pancreatic cancer. The treatment of PEI is oral pancreatic enzymes replacement therapy (pancreatic extracts, in the middle of meals, with adapted doses), associated with nutritional support and management of diabetes if necessary.
This symposium summarized the physiology of the exocrine pancreas, the causes of EPI, the consequences, especially in patients with pancreatic cancer, and its treatment.