Enzyme replacement therapy for maldigestion syndrome: clinical surveillances
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maldigestion, exocrine pancreatic insufficiency, chronic pancreatitis, celiac disease, 13С-triglyceride breath test, 13С-corn starch breath test

How to Cite

Chernyavskiy, V. V., Gvozdetska, L. S., & Parunyan, L. M. (2017). Enzyme replacement therapy for maldigestion syndrome: clinical surveillances. Herald of Pancreatic Club, 34(1), 32-37. https://doi.org/10.33149/vkp.2017.01.06

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Maldigestion persists in most patients with chronic pancreatitis (CP) and celiac disease. The objective lipase and amylase insufficiency diagnosis is needed to achieve an adequate clinical response to oral pancreatic enzyme substitution therapy. The novel data are presented in the article on the role of 13C-mixed triglyceride and 13C-corn starch breath tests as tools for exocrine pancreatic insufficiency diagnostics, for evaluating fat and starch malabsorbtion in CP patients. 165 patients (135 with CP and 30 with CP + celiac disease) and 30 healthy volunteers were included in the investigation. Delayed results of enzyme replacement therapy for maldigestion were estimated in 1 and 2 year of surveillance. It has been shown that partial recovery of exocrine pancreatic function is possible, and replacement therapy leads to patients’ nutritional status improving. It has been shown that 13C-breath tests could be useful tools in clinical practice for CP diagnostics. They are well-correlated with fecal elastase-1 level, have high sensitivity and specificity for diagnostics of lipase and amylase deficiency. Tests make it possible to choose the initial pancreatic enzyme dosage and are beneficial during the treatment for pancreatic enzyme dose correction.

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