Pancreas Insufficiency

Exocrine Pancreas Insufficiency is usually diagnosed in the first year of life. Due to the lack of pancreas enzyme fat and fat-soluble vitamins are not absorbed in the gut.

There is no doubt that pancreatic enzyme replacement therapy (PERT) is indicated in patients with EPI.

If PERT is conducted properly, no fat restrictions are necessary. Patients should take Pancreatin along with a normal diet instead of changing their diet. If there are deficits in fat-soluble vitamins (A, D, E), prothrombin time as a surrogate for vitamin K and trace elements should be recorded, these should be substituted accordingly.

Blood levels of fat-soluble vitamins should be measured every 6 to 12 months in young children, and supplementary therapy should be started if values are low. It is important to ensure compliance with pancreatic enzyme supplementation, as deficiencies of these vitamins are an indirect marker of fat malabsorption.

Last modified
2 April 2020

A09AA02 Pancreatine

Creon, Pancrease, Panzytrat


14905-4 Retinol (Vitamin A) in serum/plasma

Units: moles/volume (μmol/L)

14635-7 Calcidiol (25-hydroxy-Vitamin D3) in serum/plasma

Units: moles/volume (nmol/L)

14590-4 Alpha tocopherol (Vitamin E) in serum/plasma

Units: moles/volume (μmol/L)

5901-4 Prothrombin time (PT) in Control Platelet poor plasma by Coagulation assay

Units: time (seconds)

34714-6 INR in Blood by Coagulation assay

Units: INR

58793-1 Vitamin K (Fytonadion) in serum/plasma

Units: moles/volume (nmol/L)

25907-7 Pancreatic Elastase in Stool

Units: Mass/mass (μg/g)

3066-8 Serum Trypsinogen in serum/plasma

Units: Mass/volume (μg/L)

14589-6 Amylase isoenzymes in serum/plasma

Units: units/volume (U/L) + Interpretation

3040-3 24 Fat balance in serum/plasma

Units: units/volume (103 U/L)


K86.81 Exocrine pancreatic insufficiency

Rare Condition

Shwachman Diamond Syndrome

Shwachman-Diamond syndrome is complex condition which affects different body functions.

The pancreas  produces less enzymes for the uptake of food. 

The bone marrow malfunctions and...

General Medical Guideline