Treatment of Protein Malnutrition and Uncontrollable Diarrhea Following Bilio-pancreatic Diversion with Pancreas Extract Viokase

Thirteen patients, following a bilio-pancreatic diversion procedure for obesity, developed severe nutritional complications such as protein deficiency, anemia, hypocalcemia and/or gastro-intestinal problems (uncontrollable diarrhea). They were subjected to a new therapeutic approach-the administration of pancreas extract tablets Viokase, containing protease, lipase and amylase. This, together with protein-rich food resulted after 2-4 weeks of treatment in a drastic reduction in the number of daily stools: from 10-12 per day to 4-6 per day, as well as the disappearance of the accompanying foul smell and the malodourous gas emissions. After a further 4-8 weeks of treatment of those patients with protein deficiency, the serum protein-albumin levels as well as the Hgb and Ca levels rose to near normal values: protein from 4.8-5.5 g% to 6-6.5 g%; albumin from 1.8-3 g% to 3.4 g% and above; Hgb from 7-9 g/dl to 11-12 g/dl; and Ca from 7.5-7.8 mg% to 8-9 mg%. None of the patients treated with pancreas extract for protein deficiency required rehospitalization for intravenous protein replacement, nor was there any need observed for operative revision or takedown in these patients.