Title: Lipids digestion disturbance in children with cystic fibrosis and chronic pancreatitis
- Ewa Barra, Jerzy Socha, Mikołaj Teisseyre, Danuta Celińska-Cedro, Anna Stolarczyk, Jan Pertkiewicz, Małgorzata Kowalska, Marzena Skoczeń, Zbigniew Wawer
- Contemporary Pediatrics, Gastroenterology, Hepatology and Child Feeding
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- cystic fibrosis, chronic pancreatitis, fat balance, chymotrypsin, elastase 1
Introduction Pancreatic insufficiency in the course of cystic fibrosis and chronic pancreatitis is usually associated with fat maldigestion and malabsorption.
The aim of the study: The aim of the study was the estimation of lipids digestion and absorption in children with cystic fibrosis and chronic pancreatitis.
Material and Methods: This study included 20 children with cystic fibrosis aged 4-18 years and 21 children with chronic pancreatitis aged 4-15 years. Abdominal ultrasonography and endoscopic retrograde cholan-giopancreatography was used for visual evaluation of the pancreas. Pancreatic function was evaluated on the basis of the 24 hours fat excretion in feces, chymotrypsin and elastase 1 concentration in feces. Results: In children with cystic fibrosis increased 24 hours fat excretion in feces was observed in the com-parison with the children with pancreatic insufficiency (33.3± 18.2 g/24 h vs. 2.7±1.7 g/24h). In all children with cystic fibrosis and in 13/21 (62%) children with chronic pancreatitis decreased activity of chymotrypsin in feces was observed. The activity of elastase 1 in all children with cystic fibrosis and in 12/21 (57%) children with chronic pancreatitis was significantly decreased.
Conclusion: 1) In children with chronic pancreatitis, contrary to children with cystic fibrosis, we didn't observe increased fecal fat excretion. 2) In the treatment of cystic fibrosis enzymatic supplementation depends on pancreatic insufficiency degree. High doses of pancreatic enzymes, contrary children with cystic fibrosis, was not necessary. 3) Children with chronic pancreatitis didn't need increased energetic supply.