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Management of Exocrine Pancreatic Insufficiency in Children

Senthilkumar Sankararaman1, Teresa Schindler2, Thomas J Sferra1

  • 1Division of Pediatric Gastroenterology, Department of Pediatrics, UH Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
|September 20, 2019
PubMed

Insights

Diagnosing exocrine pancreatic insufficiency (EPI) in children is challenging. Early diagnosis and treatment with pancreatic enzyme replacement therapy and nutritional support are crucial for growth and preventing malabsorption.

Area of Science:

  • Pediatric Gastroenterology
  • Nutritional Science
  • Endocrinology

Background:

  • Exocrine pancreatic insufficiency (EPI) diagnosis can be difficult due to nonspecific symptoms.
  • Delayed diagnosis negatively impacts children's health, causing poor weight gain, impaired growth, and malabsorption.
  • Children are particularly vulnerable to untreated EPI consequences due to active growth and development.

Purpose of the Study:

  • To highlight the diagnostic challenges of EPI in children.
  • To emphasize the importance of timely diagnosis and management.
  • To review current therapeutic strategies for pediatric EPI.

Main Methods:

  • Literature review focusing on pediatric exocrine pancreatic insufficiency.
  • Analysis of diagnostic criteria and clinical presentation.
  • Evaluation of treatment outcomes for pancreatic enzyme replacement therapy and nutritional support.

Main Results:

  • Pancreatic enzyme replacement therapy is essential for symptomatic relief and improved clinical outcomes.
  • A high-energy diet, unrestricted fat intake, and fat-soluble vitamin supplementation are vital for optimal growth.
  • Cystic fibrosis is the leading cause of pediatric EPI, with nutritional improvements linked to better pulmonary function and survival.

Conclusions:

  • Effective management of pediatric EPI requires prompt diagnosis and comprehensive treatment.
  • Nutritional support and pancreatic enzyme replacement therapy are cornerstones of care.
  • Further research is needed for managing non-CF causes of EPI in children.

Keywords:
childcystic fibrosisexocrine pancreatic insufficiencyfat-soluble vitaminsnutrition therapypancreatic diseasespediatrics

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