Advertisement

Diagnostik und Therapie der Pankreasinsuffizienz

  • W. F. Caspary
Conference paper

Zusammenfassung

Die wichtigsten Nahrungsbestandteile des Menschen sind Kohlenhydrate, Proteine und Fette. Beim Assimilationsprozeß unterscheiden wir zwischen einer digestiven und einer resorptiven Phase der Verdauung [8].

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. 1.
    Adler G (1988) Enzymsubstitution zur Behandlung der Schmerzen bei chronischer Pankreatitis. Bedeutung der Feedback-Regulation für die Pankreassekretion. Dtsch Med Wochenschr 113: 1075–1079PubMedCrossRefGoogle Scholar
  2. 2.
    Becker HD, Caspary WF (1980) Postvagotomy and postgastrectomy syndromes. Springer, Berlin Heidelberg New YorkGoogle Scholar
  3. 3.
    Boivin M, Lanspa SJ, Zinsmeister AR, Go VLW, DiMagno EP (1990) Are diets associated with different rates of human interdigestive and postprandial pancreatic secretion? Gastroenterology 99: 1763–1771PubMedGoogle Scholar
  4. 4.
    Brunner H, Northfield TC, Hofmann AF, Go VLW, Summerskill WHJ (1974) Gastric emptying and secretion of bile acids, cholesterol, and pancreatic enzymes during digestion. Duodenal perfusion studies in healthy subjects. Mayo Clin Proc 49: 851–860Google Scholar
  5. 5.
    Caspary WF (1983) Resorption von Oxalsäure und intestinale Hyperoxalurie. In: Caspary WF (Hrsg) Handbuch der Inneren Medizin, Dünndarm, Band 3/3A. Springer, Berlin Heidelberg New York, S 298–308Google Scholar
  6. 6.
    Caspary WF (1984) Stärkeblocker als Schlankmacher? Med Klin 79: 236–238Google Scholar
  7. 7.
    Caspary WF (1986) Diarrhoea associated with carbohydrate malabsorption. Clin Gastroenterol 15: 631–655PubMedGoogle Scholar
  8. 8.
    Caspary WF (1987) Pathophysiologie von Malassimilationssyndromen. In: Caspary WF (Hrsg) Struktur und Funktion des Dünndarms. Excerpta Medica, Amsterdam, S 143–163Google Scholar
  9. 9.
    Chen W-L, Morishita R, Eguchi T (1989) Clinical usefulness of dual-labeled Schilling test for pancreatic exocrine function. Gastroenterology 96: 1337–1341PubMedGoogle Scholar
  10. 10.
    Chung JB, Tohno H, Sarr MG, DiMagno EP (1990) Gastric emptying (GE) of carbohydrate (CHO), fast (F) and protein ( P) and secretion of each nutrient’s specific hydrolytic enzyme in dogs. Pancreas 5: 702Google Scholar
  11. 11.
    Cole SG, Rossi S, Stern A, Hofmann AF (1987) Cholesteryl octanoate breath test. Gastroentereology 93: 1372–1375Google Scholar
  12. 12.
    DiMagno EP (1989) Medical treatment of pancreatic insufficiency. Mayo Clin Proc 54: 435–442Google Scholar
  13. 13.
    DiMagno EP (1991) Patterns of human exocrine pancreatic secretion and fate of human pancreatic enzymes during aboral transit. In: Lankisch PG (ed) Pancreatic enzymes in health and disease. Springer, Berlin Heidelberg New York Tokyo, pp 1–10Google Scholar
  14. 14.
    DiMagno EP (1991) Tests of gastric and exocrine pancreatic function and absorption. In: Yamada T (ed) Textbook of Gastroenterology. Lippincott, Philadelphia, pp 2561–2575Google Scholar
  15. 15.
    DiMagno EP (1991) Future aspects of enzyme replacement therapy. In: Lankisch PG (ed) Pancreatic enzymes in health and disease. Springer, Berlin Heidelberg New York Tokyo, pp 209–214Google Scholar
  16. 16.
    DiMagno EP, Go VLW, Summerskill WHJ (1973) Relations between pancreatic enzyme outputs and malabsorption in severe pancreatic insufficiency. N Engl J Med 288: 813–815PubMedCrossRefGoogle Scholar
  17. 17.
    DiMagno EP, Hendricks JC, Go VLW, Dozois RR (1979) Relations among canine fasting pancreatic and biliary secretions, pancreatic duct pressure and duodenal phase III motor activity — Boldyref revisted. Dig Dis Sci 24: 689–693PubMedCrossRefGoogle Scholar
  18. 18.
    DiMagno EP, Malagelada J-R, Go VLW, Moertel CG (1977) Fate of orally ingested enzymes in pancreatic insufficiency: comparison of two dosage schedules. N Engl J Med 296: 1318–1322PubMedCrossRefGoogle Scholar
  19. 19.
    Domschke S, Heptner G, Kolb S, Sailer D, Schneider MU, Domschke W (1986) Decrease in plasma amino acid level after secretin and pancreozymin as an indicator of exocrine pancreatic function. Gastroentereology 90: 1031–1038Google Scholar
  20. 20.
    Elsenhans B, Caspary WF (1983) Resorption von Eiweiß. In: Caspary WF (Hrsg) Handbuch der Inneren Medizin, Dünndarm, Band 3/3A. Springer, Berlin Heidelberg New York, S 157–170Google Scholar
  21. 21.
    Fölsch UR (1989) Pankreasenzympräparate zur Schmerztherapie bei chronischer Pankreatitis. Dtsch Ärztebl 86: 792–793Google Scholar
  22. 22.
    Gangl A (1983) Resorption von Triglyceriden und fettlöslichen Vitaminen (außer Vitamin D). In: Caspary WF (Hrsg) Handbuch der Inneren Medizin, Dünndarm, Band 3/3A. Springer, Berlin Heidelberg New York, S 179–215Google Scholar
  23. 23.
    Graham DY (1982) Pancreatic enzyme replacement. The effect of antacids or cimetidine. Dig Dis Sci 27: 48. 5–490Google Scholar
  24. 24.
    Gullo L, Pezzili R, Ventrucci M (1989) Cerulein-induced plasma amino acid decrease: a simple, sensitive, and specific test for pancreatic function. Pancreas 4: 619CrossRefGoogle Scholar
  25. 25.
    Hiele M, Ghoos Y, Rutgeerts P, Vantrappen G (1989) Starch digestion in normal subjects and patients with pancreatic disease, using a 13CO2 breath test. Gastroentereology 96: 503–509Google Scholar
  26. 26.
    Holgate AM, Read NW (1985) Effect of ileal infusion of intralipid on gastrointestinal transit, ileal flow rate, and carbohydrate absorption in humans after ingestion of a liquid meal. Gastroentereology 88: 1005–1011Google Scholar
  27. 27.
    Ihse I (1990) Pancreatic pain causes, diagnosis, and treatment. Acta Chir Scand: 257–321Google Scholar
  28. 28.
    Ihse I (1991) Treatment of pain in chronic pancreatitis with pancreatic enzymes. In: Lankisch PG (ed) Pancreatic enzymes in health and disease. Springer, Berlin Heidelberg New York Tokyo, pp 89–94Google Scholar
  29. 29.
    Ihse I, Liija P, Lundqvist K (1977) Feedback regulation of pancreatic enzyme secretion by intestinal trypsin in man. Digestion 15: 303–308PubMedCrossRefGoogle Scholar
  30. 30.
    Isacksson G, Ihse I (1983) Pain reduction by an oral pancreatic enzyme preparation in chronic pancreatitis. Dig Dis Sci 28: 97–102CrossRefGoogle Scholar
  31. 31.
    Kelleher J (1981) Nutritional status in chronic pancreatic steatorrhea. In: Mitchell CJ, Kelleher J (eds) Pancreatic Disease in Clinical Practice. Pitman, London, pp 257–266Google Scholar
  32. 32.
    Kerlin P, Wong L, Capra S (1984) Rice flour, breath hydrogen, and malabsorption. Gastroentereology 87: 578–585Google Scholar
  33. 33.
    Lankisch PG (1982) Progress report: exocrine pancreatic function tests. Gut 23: 777–780PubMedCrossRefGoogle Scholar
  34. 34.
    Lankisch PG (1984) Secretin test or secretin-CCK test — gold standard in pancreatic function testing? In: Gyr KE, Singer MV, Sarles H (eds) Pancreatitis — concepts and classification. Excerpta Medica, Amsterdam New York Oxford, pp 247–252Google Scholar
  35. 35.
    Lankisch PG (1985) Die chronische Pankreatitis. Neue Aspekte der Ätiologie, Diagnostik und Therapie. Internist Welt 7: 201–210Google Scholar
  36. 36.
    Lankisch PH (1989) Exokrine Pankreasinsuffizienz: rationale und rationelle Funktionsdiagnostik. Dtsch Med Wochenschr 114: 715–717PubMedCrossRefGoogle Scholar
  37. 37.
    Lankisch PG (1991) Differential treatment of exocrine pancreatic insufficiency in chronic pancreatitis. In: Lankisch PG (ed) Pancreatic enzymes in health and disease. Springer, Berlin Heidelberg New York Tokyo, pp 191–208Google Scholar
  38. 38.
    Lankisch PG, Brauneis J, Otto J, Göke B (1986) Pancreolauryl and NBT-PABA tests. Are serum tests more practicable alternatives to urine tests in the diagnosis of exocrine pancreatic insufficiency? Gastroentereology 90: 350–354Google Scholar
  39. 39.
    Lankisch PG, Lembcke B, Wemken G, Creutzfeldt W (1986) Functional reserve capacity of the exocrine pancreas. Digestion 35: 175–181PubMedCrossRefGoogle Scholar
  40. 40.
    Lankisch PG, Otto J, Brauneis J, Hilgers R, Lembcke B (1988) Detection of pancreatic steatorrhea by oral pancreatic function tests. Dig Dis Sci 33: 1233–1236PubMedCrossRefGoogle Scholar
  41. 41.
    Layer P, Go VLW, DiMagno EP (1986) Fate of pancreatic enzymes during small intestinal aboral transit in humans. Am J Physiol 251:G 475-G 480Google Scholar
  42. 42.
    Lembcke B, Stein J (1991) Vitamin deficiency in chronic pancreatitis: assessment and treatment. In: Lankisch PG (ed) Pancreatic enzymes in health and disease. Springer, Berlin Heidelberg New York Tokyo, pp 155–165Google Scholar
  43. 43.
    Liddle RA (1991) Congenital and hereditary diseases of the pancreas. In: Yamada T (ed) Textbook of gastroenterology. Lippincott, Philadelphia, pp 1937–1951Google Scholar
  44. 44.
    Liener JE, Goodale RL, Doshmukh A et al. (1988) Effect of a trypsin inhibitor from soya-beans (Bowman-Birk) on the secretory activity of the human pancreas. Gastroentereology 94: 419–427Google Scholar
  45. 45.
    Littlewood JM (1991) Pancreatic enzymes in cystic fibrosis. In: Lankisch PG (ed) Pancreatic enzymes in health and disease. Springer, Berlin Heidelberg New York Tokyo, pp 178–189Google Scholar
  46. 46.
    Meyer JH (1991) Delivery of pancreatin in microsphere preparations: transit, timing, and physiological needs. In: Lankisch PG (ed) Pancreatic enzymes in health and disease. Springer, Berlin Heidelberg New York Tokyo, pp 71–88Google Scholar
  47. 47.
    Mössner J, Secknus R, Meyer J, Niederau C, Adler G (1991) Schmerzbehandlung der chronischen Pankreatitis mit Pankreasenzym. Ergebnisse einer Multizenter-Studie. Z Gastroentereologie 29: 483 (abstr)Google Scholar
  48. 48.
    Mundlos S, Kühnelt P, Adler G (1991) Monitoring enzyme replacement treatment in exocrine pancreatic insufficiency using the cholesteryl octanoate breath test. Gut 31: 1324–1328CrossRefGoogle Scholar
  49. 49.
    Newcomer AD, Hofmann AF, DiMagno EP, Thomas PJ, Carlson GL (1979) Triolein breath test: a sensitive and specific test for fat malabsorption. Gastroentereology 76: 6–11Google Scholar
  50. 50.
    Owyang C, Louie D, Tatum D (1986) Feedback regulation of pancreatic enzyme secretion. J Clin Invest 77: 2042–2047PubMedCrossRefGoogle Scholar
  51. 51.
    Patel VP, Jain NK, Agarwal N, Gee Varghese PJ, Pitchumoni CS (1986) Comparison of benturomide test and rice flour breath hydrogen test in the detection of exocrine pancreatic insufficiency. Pancreas 1: 172PubMedCrossRefGoogle Scholar
  52. 52.
    Ramo DJ, Puolakkainen PA, Seppalo K (1989) Self-administration of enzyme substitution in the treatment of exocrine pancreatic insufficiency. Scand J Gastroenterol 24: 688PubMedCrossRefGoogle Scholar
  53. 53.
    Reagan PT, Malagelada J-R, DiMagno EP, Go VLW (1977) Comparative effects of antacids, cimetidine and enteric coating on the therapeutic response to oral enzymes in severe pancreatic insufficiency. N Engl J Med 297: 854–858CrossRefGoogle Scholar
  54. 54.
    Reagan PT, Malagelada J-R, DiMagno EP, Go VLW (1979) Reduced intraluminal bile acid concentration and fat maldigestion in pancreatic insufficiency: correction by treatment. Gastroentereology 77: 285–289Google Scholar
  55. 55.
    Roy CC, Weber AM, Lapage G, Smith L, Levy E (1988) Digestive and absorptive phase anomalies associated with the exocrine pancreatic insufficiency of cystic fibrosis. J Pediatr Gastroenterol Nutr 7 [Suppl 1]:S 1-S 7CrossRefGoogle Scholar
  56. 56.
    Slaff J, Jacobson D, Tillman CR, Curington C, Toskes P (1984) Protease-specific suppression of exocrine pancreatic secretion. Gastroentereology 87: 44–52Google Scholar
  57. 57.
    Stafford RJ, Grand RJ (1982) Hereditary disease of the exocrine pancreas. Clin Gastroenterol 11: 141–170PubMedGoogle Scholar
  58. 58.
    Stein J, Bienek U, Lembcke B (1991) Infrarotspektroskopische Stuhlfettbestimmung: Vergleich mit der van-de-Kamer-Methode. Z Gastroenterologie 29: 506 (abstr)Google Scholar
  59. 59.
    Sziegoleit A, Linder D (1991) Die menschliche Pankreaselastase 1. Biochemische und klinische Aspekte. Med Welt 42: 682–684Google Scholar
  60. 60.
    Thiruvengadam R, DiMagno EP (1988) Inactivation of human lipase by proteases. Am J Physiol 255:G 476-G 481Google Scholar
  61. 61.
    Toskes PP (1980) Current concepts of cobalamin (vitamin B12) absorption and malabsorption. J Clin Gastroenterol 2: 287–297PubMedCrossRefGoogle Scholar
  62. 62.
    van de Kamer JH, ten Bokkel Huinink H, Weijers HA (1949) Rapid method for determination of fat in feces. J Biol Chem 177: 347–349Google Scholar
  63. 63.
    Vantrappen GR, Peeters TL, Janssens J (1979) The secretory component of the interdigestive migrating motor complex in man. Scand J Gastroenterol 14: 663–667PubMedCrossRefGoogle Scholar
  64. 64.
    Vantrappen GR, Rutgeerts PJ, Ghoos YF, Hiele MI (1989) Mixed triglyceride breath test: a noninvasive test of pancreatic lipase activity in the duodenum. Gastroentereology 96: 1126–1134Google Scholar
  65. 65.
    Vuoristo M, Väänänen H, Miettinen TA (1992) Cholesterol malabsorption in pancreatic insufficiency: effect of enzyme substitution. Gastroentereology 102: 647–655Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1993

Authors and Affiliations

  • W. F. Caspary

There are no affiliations available

Personalised recommendations