Pancreatitis and Pancreatic Insufficiency

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Pancreatitis occurs less frequently than liver disease in chronic alcoholics, and is characterized by severe attacks of abdominal pain due to pancreatic inflammation, while pancreatic insufficiency is due to the eventual destruction of pancreatic cells that secrete digestive enzymes and insulin. This destructive process is associated with progressive scarring of the pancreas together with distortion and partial blockage of the pancreatic ducts, which promote recurrent episodes of acute inflammatory pancreatitis. Since the pancreas is the site of production of proteases and lipases for protein and lipid digestion, destruction of more than 90% of the pancreas results in significant malabsorption of these major dietary constituents, as well as diabetes secondary to reduced insulin secretion. Consequently, patients with pancreatic insufficiency exhibit severe loss of body fat and muscle protein. Since the absorption of fat-soluble vitamins is dependent upon pancreatic lipase for solubilization of dietary fat, these patients are also at risk for deficiencies of vitamins A, D, and E.

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