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Hoffmann, R. A wiki for the life sciences where authorship matters. Nature Genetics (2008)
 

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What to do when a patient with exocrine pancreatic insufficiency does not respond to pancreatic enzyme substitution, a practical guide.

In the majority of patients, pancreatin microsphere preparations containing 25,000-40,000 FIP units of lipase will lead to a clinical improvement and reduction of steatorrhea in patients with exocrine pancreatic insufficiency. In patients failing to respond, the following stepwise procedure is recommended: increasing enzyme dosage; checking the patient's compliance; reevaluating the diagnosis; and as a last resort to decrease fat intake or adding H2-blockers or proton pump inhibitors. Although this stepwise procedure is time-consuming, it is necessary to prevent in patients not responding to pancreatic enzyme substitution the development of late complications of exocrine pancreatic insufficiency.[1]

References

  1. What to do when a patient with exocrine pancreatic insufficiency does not respond to pancreatic enzyme substitution, a practical guide. Lankisch, P.G. Digestion (1999) [Pubmed]
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