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Prevalence of Pancreatic Insufficiency in Inflammatory Bowel Diseases. Assessment by Fecal Elastase-1

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Abstract

Pancreatic insufficiency (PI) may be an extraintestinal manifestation of inflammatory bowel diseases (IBD). We report the results of a cross-sectional study that was carried out to investigate both the prevalence of PI in IBD patients and its clinical course over a 6-month follow-up period. In total, 100 Crohn’s disease (CD) patients, 100 ulcerative colitis (UC) patients, and 100 controls were screened for PI by the fecal elastase-1 (FE-1) test. The decision limits employed were: ≤200 μg/g stool for PI and ≤100 μg/g for severe PI. Patients with abnormal FE-1 values were re-tested after 6 months. Odds ratios (OR) for PI were estimated by unconditional logistic regression analysis. PI was found in 22 UC and 14 CD patients. The OR for the FE-1 test ≤200 μg/g was 10.5 [95% confidence interval (CI): 2.5–44.8] for IBD patients compared to the controls. The risk of PI was related to three or more bowel movements per day (OR = 25.0), the passage of loose stools (OR = 7.7), and previous surgery (OR = 3.7). At the 6-month follow-up, FE-1 values became normal in 24 patients and showed persistently low concentrations in 12. These patients had a larger number of bowel movements per day (OR = 5.4), previous surgery (OR = 5.7), and a longer duration of the disease (OR = 4.2). PI is frequently found in IBD patients, particularly in those with loose stools, a larger number of bowel movements/day and previous surgery. PI is reversible in most patients, and persistent PI is not associated with clinically active disease.

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Authors and Affiliations

  1. Department of Clinical Sciences, “L. Sacco” University Hospital, Via G.B. Grassi, 74, Milan, 20157, Italy

    Giovanni Maconi (Chair of Gastroenterology), Mirko Molteni, Sandro Ardizzone, Matteo Bosani, Elisa Ferrara & Gabriele Bianchi Porro

  2. Laboratory of Clinical Chemistry, “L. Sacco” University Hospital, Milan, Italy

    Roberto Dominici

  3. Laboratory of Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy

    Silvano Gallus

  4. Department of Clinical Sciences, “L. Sacco” University Hospital, Milan, Italy

    Mauro Panteghini (Chair of Clinical Biochemistry)

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  1. Giovanni Maconi
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  2. Roberto Dominici
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  3. Mirko Molteni
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  4. Sandro Ardizzone
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  5. Matteo Bosani
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  6. Elisa Ferrara
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  7. Silvano Gallus
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  8. Mauro Panteghini
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  9. Gabriele Bianchi Porro
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Correspondence to Giovanni Maconi.

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Maconi, G., Dominici, R., Molteni, M. et al. Prevalence of Pancreatic Insufficiency in Inflammatory Bowel Diseases. Assessment by Fecal Elastase-1. Dig Dis Sci 53, 262–270 (2008). https://doi.org/10.1007/s10620-007-9852-y

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  • DOI: https://doi.org/10.1007/s10620-007-9852-y

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