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Neuroendocrine Cancer Community

Pancreatic Exocrine Insufficiency (PEI) & Pancreatic Enzyme Replacement Therapy (PERT) 

Oct 27, 2021

The pancreas is a large gland, that is located behind the stomach and joins the digestive tract via the main pancreatic duct. It has a number of different types of cells that are responsible for producing substances (enzymes, peptides, hormones) that play an essential role in converting the food we eat into fuel for the body’s cells – as well as regulating our blood sugars.

  • Exocrine function – refers to the pancreas’ ability to produce enzymes, that are released into the ducts within the pancreas. These enzymes, mixed with digestive juices, help the body to absorb nutrients, by breaking down the food we have eaten when it reaches the duodenum.
  • Endocrine function – refers to the pancreas’ ability to produce certain gut hormones, such as insulin and glucagon, which are released directly into the bloodstream (rather than through ducts). These gut hormones aid digestion by controlling certain functions of the gut, as well as helping to regulate and control our blood sugar levels.

Pancreatic Exocrine Insufficiency (PEI), can result in malnutrition, due to malabsorption of nutrients, the effects of the underlying pancreatic disease and the impact of the symptoms on oral intake.

Symptoms may include steatorrhoea (pale, fatty/greasy, loose stools) weight loss, diarrhoea, abdominal pain and bloating.

Pancreatic enzyme replacement therapy (PERT) is the cornerstone of treatment and is associated with improved survival and quality of life (QoL) in patients with PEI.

Phillips et al. (2021) Consensus for the management of pancreatic exocrine insufficiency: UK practical guidelines. BMJ Open Gastro 2021 

As part of our NEN Nutrition Week, we would like to share with you a link to the Pancreatic Enzymes video by Mary Phillips – HPB and Intensive Care Dietitian Royal Surrey Hospital, Guildford.  

Mary is a very experienced Pancreatic Dietitian, co-author of the UK Practical Guidelines – and was kind enough to attend and speak at a recently held Surrey & Sussex Natter Group:

Pancreatic Enzymes : A video guide for patients :

or you can read the presentation featured in the video here –  Pancreatic enzymes: a guide for patients.

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