The pancreas produces three important enzymes including amylase, lipase and protease. The primary function of these enzymes (mainly lipase) is to assist in the breakdown of triglycerides into fatty acids, which are then absorbed with the help of bile salts. Under normal conditions, the pancreas stores large volumes of these enzymes.
Pancreatic insufficiency is a condition which is associated with failure of the intestine to digest the food, resulting in indigestion. Pancreatic insufficiency occurs when the production of the key enzymes drops below 10% of its normal levels.
Unfortunately there is little information available about the prevalence related to this disease condition. In a German study conducted, it was observed that the age adjusted prevalence of the condition is 8 per 100,000 for men and 2 per 100,000 for women.
The outlook of the condition also depends upon the cause, e.g. the prognosis for alcohol induced pancreatic insufficiency is much better if alcohol consumption is stopped, whereas not good for people with pancreatic insufficiency caused due to autoimmune disorders.
What Are The Causes Of Pancreatic Insufficiency?
The causes of pancreatic insufficiency can be categorized into pancreatic and non-pancreatic.
- Chronic pancreatitis is the most common cause for the development of this condition, which is associated with fibrosis and necrosis of the cells resulting in loss of functioning.
- Cystic fibrosis can reduce the water content of the secretions thereby resulting in precipitation of the proteins and blocking of the ductules, causing inadequate supply of pancreatic enzymes to the gut. This results in auto-digestion of pancreatic cells resulting in acute pancreatitis.
- Pancreatic cancer or tumors can cause obstruction of the pancreatic duct resulting in inadequate supply of pancreatic enzymes to the gut and trigger pancreatic insufficiency.
- Shwachman-Diamond Syndrome is an autosomal disorder which is rare and associated with pancreatic insufficiency, leukemia, bone marrow dysfunction and skeletal abnormalities.
Non pancreatic causes for the condition include,
- Celiac disease
- Crohn’s disease
- Zollinger-Ellison Syndrome
- Surgical procedures involving the gastrointestinal tract or pancreas.
How To Diagnose Pancreatic Insufficiency?
There are series of tests that need to be performed with a focus not only on diagnosis of pancreatic insufficiency but to also evaluate the level of mal-absorption and identify underlying disease responsible for the condition.
- Complete blood profiling is done. Anemia is observed due to Vitamin B12/ folate deficiency. PT may be prolonged in case of mal-absorption.
- Serum levels of antigliadin/ antiedomysial antibodies can help in the diagnosis of celiac disease.
- Fat Absorption tests, D-xylose test, carbohydrate absorption test, bile salt absorption test and Schilling test may be performed to understand the extent of mal-absorption.
- Pancreatic function tests are performed to evaluate the functioning of the pancreas. An ultrasound scan of the abdomen is performed in order to confirm any anatomical or pathological abnormality.
Natural Treatment For Pancreatic Insufficiency
There are certain lifestyle modifications and natural treatment options that may be beneficial,
- Avoid fatty food and limit the intake of alcohol.
- Stop smoking
- Consume a healthy and balanced diet rich in vegetables, fruits and dairy products.
- Include vitamin supplements namely fat soluble vitamins like Vitamin A, Vitamin D and Vitamin K in your diet.
Pancreatic enzyme therapy is considered to be the primary therapeutic treatment for the management of the condition. Pancreatic enzyme therapy helps complement the shortage of enzymes required for digestion of fats and improves digestive process.