Evidences of nutritional deficiencies were much less frequent in 90 patients with untreated or inadequately treated chronic exocrine pancreatic insufficiency, many with marked steatorrhea, than in a previous series of patients with nontropical sprue. Hemorrhage due to prothrombin deficiency and osteomalacia associated with bone pain or hypocalcemic tetany, common in patients with nontropical sprue, were not encountered in the patients with exocrine pancreatic insufficiency. Furthermore, no patient in the series had a blood hemoglobin concentration below 10.gm./100 ml., whereas 21% of patients with nontropical sprue had values below this level. Two patients had anemia due to Vitamin B12 deficiency but none had anemia due to iron or folic acid deficiency. Factors possibly responsible for these findings include shorter duration of exocrine pancreatic insufficiency than nontropical sprue, small-bowel mucosal damage characteristic of nontropical sprue but absent in exocrine pancreatic insufficiency, and increased food intake in exocrine pancreatic insufficiency.
Absence of severe nutritional deficiency states may help differentiate exocrine pancreatic insufficiency from other malabsorption states. Also diagnostically helpful is passage by rectum of gross oil separate from the rest of the fecal bulk, common in exocrine pancreatic insufficiency but apparently not occurring in malabsorption syndromes having other causes.
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Evans, W.B., Wollaeger, E.E. Incidence and severity of nutritional deficiency states in chronic exocrine pancreatic insufficiency: Comparison with nontropical sprue. Digest Dis Sci 11, 594–606 (1966). https://doi.org/10.1007/BF02233507
- Folic Acid
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- Increase Food Intake