- Mehrdad Nikfarjam1,2
- Jeremy S Wilson3
- Ross C Smith4
- Australasian Pancreatic Club Pancreatic Enzyme Replacement Therapy Guidelines Working Group
- 1 Austin Health, Melbourne, VIC
- 2 University of Melbourne, Melbourne, VIC
- 3 South Western Sydney Clinical School, Liverpool Hospital, UNSW, Sydney, NSW
- 4 Kolling Institute, Royal North Shore Hospital, University of Sydney, Sydney, NSW
Correspondence: mehrdad.nikfarjam@gmail.com
Acknowledgements:
Members of the APC PERT Guidelines Working Group are listed in the full guidelines available at http://pancreas.org.au/2016/01/pancreatic-exocrine-insufficiency-guidelines. We thank Ergo Advertising for their assistance in creating the flowcharts in this article and editing earlier versions of the manuscript.
Competing interests:
The APC has received unrestricted educational funding from Mylan Pharmaceuticals. There has been no funding directed to any of the authors in relation to this article or the production of the APC guidelines for the management of PEI.
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Abstract
Introduction: In 2015, the Australasian Pancreatic Club (APC) published the Australasian guidelines for the management of pancreatic exocrine insufficiency (http://pancreas.org.au/2016/01/pancreatic-exocrine-insufficiency-guidelines). Pancreatic exocrine insufficiency (PEI) occurs when normal digestion cannot be sustained due to insufficient pancreatic digestive enzyme activity. This may be related to a breakdown, at any point, in the pancreatic digestive chain: pancreatic stimulation; synthesis, release or transportation of pancreatic enzymes; or synchronisation of secretions to mix with ingested food.
Main recommendations: The guidelines provide advice on diagnosis and management of PEI, noting the following:
Changes in management as a result of these guidelines: These are the first guidelines to classify PEI as being definite, possible or unlikely, and provide a diagnostic algorithm to facilitate the early diagnosis of PEI and appropriate use of PERT.