European guideline for the diagnosis and therapy of pancreatic exocrine insufficiency: UEG, EPC, EDS, espghan, esdo, and espcg evidence-based statements
Abstract
Pancreatic exocrine insufficiency (PEI) is defined as a reduction in pancreatic exocrine secretion below a level that allows normal digestion of nutrients. Pancreatic disease and pancreatic surgery are the main causes of PEI, but other conditions and upper gastrointestinal surgery can affect the digestive function of the pancreas. PEI can cause symptoms of nutrient malabsorption and nutritional deficiencies, which affect quality of life and increase morbidity and mortality. There is no test allowing for the diagnosis of PEI. Diagnosis should therefore be based on a global assessment of symptoms, nutritional status and a pancreatic secretion test (e.g. faecal elastase). Pancreatic enzyme replacement therapy, together with dietary advice and support, are the cornerstones of PEI therapy. The diagnosis and treatment of PEI varies widely between countries and centres, and there is considerable discrepancies as to whom and how to diagnose and treat. Following the UEG framework for the development of high-quality clinical guidelines, the European multidisciplinary guideline on the diagnosis and treatment of PEI has been developed. This evidence-based guideline summarises the prevalence, clinical impact and general diagnostic and therapeutic approach to PEI, as well as the specifics of PEI in different clinical conditions. Finally, unmet needs for future research are discussed.
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