Abstract
Exocrine pancreatic function was studied by means of secretin/pancreozymin stimulation in 50 patients with small bowel disease. Forty-five patients had clinical and biochemical evidence of malabsorption. In none of the patients was there evidence of primary pancreatic disease. Impaired amylase or bicarbonate concentration was found in 62% of the patients; however, in only 6 was there gross pancreatic insufficiency and in only 2 of these was the volume output also decreased. Insufficient dietary protein intake, malabsorption and protein loss in the bowel, with subsequent amino acid and albumin deficiency, are suggested as major causes of pancreatic dysfunction in small bowel disease. In some cases a combination of factors, including folic acid deficiency and chronic malnutrition secondary to intestinal disease with weight loss, are likely causes. In this series, pancreatic function was abnormal in 78% of patients with low serum albumin and 52% of patients with normal serum albumin. The pancreatic insufficiency in intestinal disease is rarely as pronounced as that found in pancreatic steatorrhea; there is usually little difficulty in distinguishing the two, although the secretin/pancreozymin test is not completely discriminatory.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Dreiling DA: Studies in pancreatic function V. Gastroenterology 24:540–555, 1953
Marks IN, Bank S: The aetiology, clinical features and diagnosis of pancreatitis in the South Western Cape. S Afr Med J 37:1039–1053, 1963
Banwell JG, Northam BE, Cooke W: The secretory response of the human pancreas to continuous I–V cecekin. Gut 8:380–387, 1967
Fernanez LB, De Paula A, Prizont R, et al: Exocrine pancreatic insufficiency secondary to gluten enteropathy. Am J Gastroenterol 53:564–569, 1970
Comfort MW, Dornberger GR, Wollaeger EE, et al: External pancreatic secretion as measured by the secretin test in patients with idiopathic steatorrhea. Gastroenterology 13:135–140, 1949
Van de Kamer JH, Huinick HTB, Weyers HA: Rapid method for the determination of fat in the faeces. J Biol Chem 177:347–355, 1949
Bank S, Marks IN, Kench JE, et al: The reliability of131I triolein test in steatorrhoea, National Conference on Nuclear Energy South Africa. 1963, pp 304–316
Novis BH, Bank S, Marks IN: The spectrum of the malabosorption syndrome in the South Western Cape. S Afr Med J 46:455–462, 1972
Marks IN, Tompsett SL: The diagnosis of pancreatic disease. Q. J Med NS 27:431–461, 1958
Bank S, Marks IN, Moshal MG, et al: The pancreatic function test—method and normal values. S Afr Med J 37:1061–1066, 1963
Marks IN, Bank S, Louw JH: Progress in Gastroenterology. New York, Grune and Stratton, 1968, p 412
Dreiling DA: The malabsorption syndrome. Edited by D Aldersberg. A Mount Sinai Hospital Monograph, 1957, pp 69–76
Dreiling DA, Janowitz HD: The exocrine pancreas, Ciba Foundation Symposium. Boston, 1962, p 225
Barbezat GO, Hansen JDL: The exocrine pancreas and protein-calorie malnutrition. Paediatr 42:77–92, 1968
MacDonald RA, Jones RS, Pecket GS: Folic acid deficiency and haemochromatosis. Arch Pathol 80:153–160, 1965
Popper HL: Pathological aspects of pancreatic disease. Rev Gastroenterol 19:183, 1952
Bank S, Marks IN, Beck OAA: Gastric, intestinal and hepatic function in pancreatitis, The Proceedings of the Third World Congress of Gastroenterology. Vol IV. Recent Advances in Gastroenterology. 1967, pp 412–415
Bank S, Marks IN, Novis BH: Unpublished data
Author information
Authors and Affiliations
Additional information
Supported by the Medical Research Council of South Africa.
Rights and permissions
About this article
Cite this article
Novis, B.H., Bank, S. & Marks, I.N. Exocrine pancreatic function in intestinal malabsorption and small bowel disease. Digest Dis Sci 17, 489–494 (1972). https://doi.org/10.1007/BF02231203
Issue Date:
DOI: https://doi.org/10.1007/BF02231203