EFFECTS OF HIGH-LIPASE PANCREATIN ON FECAL FAT, NEUTRAL STEROL, BILE-ACID, AND SHORT-CHAIN FATTY-ACID EXCRETION IN PATIENTS WITH PANCREATICINSUFFICIENCY RESULTING FROM CHRONIC-PANCREATITIS

Conclusions, Steatorrhea was almost completely stopped and malabsorpti on of neutral sterols and short-chain fatty acids was reduced by treat ment of high-lipase pancreatin in Japanese patients with pancreatic in sufficiency whose dietary fat consumption is low. Methods. Fifteen pat ients with chronic pancreatitis complicated by steatorrhea who consume d an average of 48 g of dietary fats a day were selected as subjects a nd given 3 g of high-lipase pancreatin (lipase, 379,800 USP U/g), at e ach meal (total daily dose is 9 g) for a mean duration of 28.5 d. Feca l output and fecal fat neutral sterol, bile acid, and short-chain fatt y acid excretion were determined before and after the course of pancre atin therapy. Results, Pancreatin administration resulted in significa nt reductions (P < 0.01) in fecal output (from 243.2 to 149.1 g), excr etion of fecal fat, (from 12.3 to 3.9 g), animal sterols (from 816.3 t o 604.6 mg), and short-chain fatty acids (from 52.6 to 18.5 mM). In co ntrast, no marked changes were recorded in fecal excretion of p-sitost erol (a plant sterol), bile acids, or the hydroxy fatty acid fraction. -Fecal fat and short-chain fatty acid excretion showed strong correlat ions with fecal output.