Martin Sarner

In treating pancreatic exocrine insufficiency the diagnosis of a cause, wherever possible, is a first step. If there is an obstructing lesion, then its relief may be curative. Adequate management depends on dietary manipulation and enzyme replacement. A reduction in fat intake, with accentuation of protein and carbohydrate consumption, is recommended. For enzyme replacement, enteric-coated microspheres are required, taken with adequate acid-suppression with a proton-pump inhibitor. The enzyme supplements, using standard preparations of pancreatin, usually of porcine source, may be as much as 4 to 8 tablets per meal and should be taken with food. Endocrine insufficiency usually requires insulin.