GASTROENTEROLOGY ARTICLE OF THE WEEK
October 6, 2011
Dominguez-Munoz JE. Chronic pancreatitis and persistent steatorrhea: What is the correct dose of enzymes? Clin J Gastroenterol Hepatol 2011;9:541-546.
1. Treatment for steatorrhea is clearly indicated in patients with 24-hr fecal fat concentrations of
a. 2-5 g/d
b. 5-8 g/d
c. 8-15 g/d
d. >15 g/d
e. b,c and d
2. Under physiologic conditions, how many IU of lipase are secreted into the duodenal lumen?
a. 24,000
b. 48,000
c. 360,000
d. 850,000
3. The lipase contained in commercially available pancreatic enzyme preparations are from
a. humans
b. pigs
c. bulls
d. aliens
e. synthetic
True or False
4. To treat or prevent steatorrhea, supplement should deliver at least 30,000 IU of lipase into the duodenum together with the meal.
5. The entire dose of pancreatic enzyme should be taken 20 to 15 minutes before starting the meal
6. The recommended initial dose of lipase per meal should be 40,000 to 50,000 units.
7. Dietary modification including a diet with <20g of fat per day should be the initial step for the management of pancreatic insufficiency with steatorrhea
8. The half life of endogenous and exogenous enzymes is increased when a high or normal fat diet is ingested
9. The dose of pancreatic enzymes that normalizes bowel movement frequency is the correct dose
10, When using enteric-coated pancreatic enzyme
supplements, the use of acid suppression does not add to the efficacy of the
preparation