Pancreatic Enzyme Supplements and Nutrition
Information provided and written by Dr. Peter Durie, MD and Lynda
Ellis, RN
SDS is not considered a nutritional disorder. While many children
are underweight or malnourished at diagnosis, once the pancreatic
insufficiency is addressed with pancreatic enzymes, the children usually
begin to gain weight, height and gain better health. Therefore, it
is not generally recommended that feeding tubes be used. Of course,
every situation is different and only you and your doctors can figure
this out for your family member. SDS patients are generally shorter
than average.
Pancreatic Defect in SDS
The pancreas is an organ located just beyond the stomach.
It produces a number of enzymes that are essential to digest or
breakdown protein, fat, and carbohydrates. This allows the nutrients
and the fat soluble vitamins (A, D,E,K) to be absorbed in the body.
In reality, the pancreas has a very large reserve – only 2% of the
pancreas is needed for normal digestion to occur. In people with
SDS, the cells in the pancreas that make the enzymes are mostly
absent – especially in infancy. Fortunately, about 50% of patients
with SDS have a small improvement in pancreatic function, usually
after age 4 and MAY be able to stop enzyme therapy. Recent research
has suggested that when the pancreas improves for fat digestion,
there may continue to be a problem with starch (complex carbohydrates)
digestion. This may require a low dose of enzyme replacement to
prevent symptoms such as bloating or abdominal cramps after a high
starch meal.
Pancreatic Function Assessment
Pancreatic supplements should not be started until
the pancreas has been assessed properly because some people with
SDS do not need to use them. Tests such as the 72-hour fecal fat,
serum typsinogen and iso-amylase, serum vitamin levels or stool
for elastase are some of the indirect ways of assessing how the
pancreas is working. |
