What are the benefits of pancreatic enzyme replacement therapy (PERT) in the treatment of exocrine pancreatic insufficiency (EPI)?

Updated: Aug 12, 2021
  • Author: Samer Al-Kaade, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

PERT is the basis of treatment of EPI [36, 37] ; the endpoints of treatment are normalization of gut absorption and correction of nutritional deficiencies. The typical indications for initiating PERT are progressive weight loss and steatorrhea.

A literature review by de la Iglesia-García et al indicated that PERT can be effective against EPI and malnutrition associated with chronic pancreatitis. The investigators found PERT-associated improvement in the coefficient of fat absorption (CFA), as well as in serum nutritional parameters, GI symptoms, and quality of life. It was also determined that PERT’s efficacy may be increased through the use of higher enzyme doses and enteric-coated enzymes, the administration of therapy during food, and the suppression of acid. [38]

Similarly, a study by Erchinger et al indicated that in chronic pancreatitis patients with EPI, PERT diminishes fecal energy and fat loss, with the investigators finding that this reduction reached significance on a maximum PERT dose of 75,000 U per meal. [39]


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