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Improvement of fecal fat excretion after addition of omeprazole to pancrease in cystic fibrosis is related to residual exocrine function of the pancreas

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Abstract

Pancreatic function tests were performed in 11 adult cystic fibrosis (CF) patients with a fecal fat excretion of more than 10% during treatment with pancrease 2 capsules three times a day. These tests included urinary p-aminobenzoic acid (PABA) excretion, fasting serum trypsin and pancreatic polypeptide (PP), and glucose and insulin in fasting and postprandial serum. Subsequently, the patients entered a double-blind placebo-controlled crossover study to assess the effect of gastric acid inhibition by 20 mg omeprazole on fecal fat excretion. Adjunct therapy with omeprazole resulted in a reduction of fecal fat excretion in patients with residual pancreatic function. This improvement showed significant positive correlations with urinary PABA excretion and the increase in serum PP after the meal (P<0.02 and P<0.05), but not with the other parameters studied. Therefore, the addition of omeprazole to pancrease is most successful in CF patients with residual pancreatic function, determined by urinary PABA excretion or incremental PP.

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References

  1. Zentler-Munro PL: Cystic fibrosis—a gastroenterological cornucopia. Gut 28:1531–1547, 1987

    Google Scholar 

  2. Oppenheimer E, Esterly J: Pathology of cystic fibrosis.In Perspectives in Pediatric Pathology, Vol 2. Chicago, Year Book Publishers 1975, pp 241–278

    Google Scholar 

  3. Andersen D: Cystic fibrosis of the pancreas and its relation to celiac disease. Am J Dis Child 56:344–399, 1938

    Google Scholar 

  4. Park RW, Grand RJ: Gastrointestinal manifestations of cystic fibrosis: a review. Gastroenterology 81:1143–1161, 1981

    Google Scholar 

  5. Stead RJ, Skypala I, Hodson ME, Batten JC: Enteric coated microspheres of pancreatin on the treatment of cystic fibrosis: Comparison with a standard enteric coated preparation. Thorax 42:533–537, 1987

    Google Scholar 

  6. Gow R, Francis P, Bradbear R, Shepherd R: Comparative study of varying regimens to improve steatorrhoea and creatorrhoea in cystic fibrosis: Effectiveness of an entericcoated preparation with and without antacids and cimetidine. Lancet 2:1071–1074, 1981

    Google Scholar 

  7. Bouquet J, Sinaasappel M, Neyens HJ: Malabsorption in cystic fibrosis: Mechanisms and treatment. J Pediatr Gastroenterol Nutr 7(suppl 1):S30-S35, 1988

    Google Scholar 

  8. Littlewood JM, Kelleher J, Walters MP, Johnson AW.In vivo andin vitro studies of microsphere pancreatic supplements. J Pediatr Gastroenterol Nutr 7(suppl 1):S22-S29, 1988

    Google Scholar 

  9. Zentler-Munro PL, Fitzpatrick WJF, Batten JC, Northfield TC: Effect of intrajejunal acidity on aqueous phase bile acid and lipid concentrations in pancreatic steatorrhoea due to cystic fibrosis. Gut 25:500–507, 1984

    Google Scholar 

  10. Heijerman HGM, Lamers CBHW, Dijkman JH, Bakker W: Ranitidine compared with the dimethylprostaglandin E2-analogue enprostil as adjunct to pancreatic enzyme replacement in adult cystic fibrosis. Scand J Gastroenterol 25(suppl 178): 26–31, 1990

    Google Scholar 

  11. Anonymous. Omeprazole. Lancet 2: 1187–1188, 1987

  12. Walt RP, Gomes M, Wood EC, Logan LH, Pounder RE: Effect of daily oral omeprazole on 24 hour intragastric acidity. Br Med J 287:12–14, 1983

    Google Scholar 

  13. Lamers CBHW, Jansen JBMJ, Hafkenscheid JCM, Jongerius CM: Evaluation of exocrine and endocrine pancreatic function in older patients with cystic fibrosis. Pancreas 5(1):65–59, 1990

    Google Scholar 

  14. Lankisch PG: Exocrine pancreatic function tests. Gut 23:777–798, 1982

    Google Scholar 

  15. Koop H: Serum leyels of pancreatic enzymes and their clinical significance. Clin Gastroenterol 13:739–761, 1984

    Google Scholar 

  16. Stern A, Davidson GP, Kirubakaran CP, Deutsch J, Smith A, Hansky J: Pancreatic polypeptide secretion. A marker for disturbed pancreatic function in CF. Dig Dis Sci 28:870–873, 1983

    Google Scholar 

  17. Allen JM, Penketh ARL, Adrian TE, Lee YL, Sarson DL, Hodson ME, Batten JL, Bloom SR: Adult cystic fibrosis: Postprandial response of gut regulatory peptides. Gastroenterology 85:1379–1383, 1983

    Google Scholar 

  18. Hubbard VS, Wolf RO, Lester LA, Egge AC: Diagnostic and therapeutic applications of bentiromide screening test for exocrine pancreatic insufficiency in patients with cystic fibrosis. Dig Dis Sci 29:881–889, 1984

    Google Scholar 

  19. Hafkenscheid JCM, Hessels M, Jansen JBMJ, Lamers CBHW: Serum trypsin, α-amylase and lipase during bombesin stimulation in normal subjects and patients with pancreatic insufficiency. Clin Chim Acta 136:235–240, 1984

    Google Scholar 

  20. Lamers CBHW, Diemel CM, Jansen JBMJ: Comparative study of plasma pancreatic polypeptide responses to food, secretin and bombesin in normal subjects and in patients with chronic pancreatitis. Dig Dis Sci 29:102–108, 1984

    Google Scholar 

  21. Creutzfeldt W, Lamberts R, Brunner G: Serum gastrin concentrations and endocrine cell population during long-term treatment with omeprazole in man. Gut 25:A1341, 1984

    Google Scholar 

  22. Adrian TE, McKiernan J, Johnstone DI, Hiller EJ, Vyas H, Sarson DL, Bloom SR: Hormonal abnormalities of the pancreas and gut in cystic fibrosis. Gastroenterology 79:460–465, 1980

    Google Scholar 

  23. Van de Kamer JH, ten Bokkel Huinink H, Weyers HA: Rapid method for the determination of fat in faeces. J Biol Chem 177:347–355, 1949

    Google Scholar 

  24. Cox KL, Isenberg JW, Asher AB, Dooley RR: The effect of cimetidine on maldigestion in cystic fibrosis. J Pediatr 94:488–492, 1979

    Google Scholar 

  25. DiMagno EP: Controversies in the treatment of exocrine pancreatic insufficiency. Dig Dis Sci 27:485–490, 1982

    Google Scholar 

  26. Cox KL, Isenberg JN, Ament ME: Gastric hypersecretion in cystic fibrosis. J Pediatr Gastroenterol Nutr 1:559–565, 1982

    Google Scholar 

  27. Weizman ZVI, Forstner GG, Gaskin KJ, Kopelman H, Wong S, Durie PR: Bentiromide test for assessing pancreatic dysfunction using analysis of paraaminobenzoic acid in plasma and urine. Gastroenterology 89:596–604, 1985

    Google Scholar 

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Heijerman, H.G.M., Lamers, C.B.H.W., Bakker, W. et al. Improvement of fecal fat excretion after addition of omeprazole to pancrease in cystic fibrosis is related to residual exocrine function of the pancreas. Digest Dis Sci 38, 1–6 (1993). https://doi.org/10.1007/BF01296765

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  • DOI: https://doi.org/10.1007/BF01296765

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