Abstract
Summary : Exocrine pancreatic insufficiency develops smoothly , but the initial reduction is not practically be diagnosed , advanced stage , mostly replicating morphological changes can be determined by tests , post examining exocrine pancreatic capacity. When significant devastation pancreatic parenchyma and replacement of functional connective tissue is present steatorrhea , and this finding corresponds to a reduction of exocrine pancreatic secretion below 10 % of normal secretion.
Tests of exocrine pancreatic secretion are still not sufficiently sensitive for the diagnosis of early stages involvement of the pancreas , and therefore the diagnosis does not fit , plus the finding of reduced exocrine secretion does not say anything about the etiology of the disease , such as inflammation / tumor. The most accurate test is economically costly test with stimulation of glands enterohormones , but to assess the effect of therapy exocrine inadequacy of breath tests are recommended.
Treatment of exocrine pancreatic insufficiency comprising administering medicines containing pancreatin ( amylase , lipase , peptidase ) , not only for people with steatorrhea or overt pancreatic insufficiency . as a standard are recommended medication in the form of capsules containing microparticles from 1.0 to 2.0 mm long with a protective coating against inactivation enzymes contained in the microparticles of gastric hydrochloric acid. The drug should be administered with each meal , ie several times a day.
The most common mistake in the treatment of pancreatic enzymes is their underdosing. It is true that when the digestive insufficiency, when the main course, should be administered 40 000-50 000 j lipase in the morning or afternoon svačinách 25,000 j lipase.
The best remedy is to bring in food. Inadequate dosing and is associated with poor digestion and absorption of a number of substances as the image of pancreatic malabsorption.