Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2021; 9(31): 9469-9480
Published online Nov 6, 2021. doi: 10.12998/wjcc.v9.i31.9469
Associations with pancreatic exocrine insufficiency: An United Kingdom single-centre study
Benjamin M Shandro, Joshua Chen, Jennifer Ritehnia, Andrew Poullis
Benjamin M Shandro, Joshua Chen, Jennifer Ritehnia, Andrew Poullis, Department of Gastroenterology, St George's University Hospitals NHS Foundation Trust, London SW17 0QT, United Kingdom
Author contributions: Shandro BM and Poullis A conceived and designed the research study; Shandro BM, Chen J and Ritehnia J collected and analysed data; Shandro BM drafted the manuscript; all authors made critical revisions to the manuscript and approved the final version to be published.
Institutional review board statement: This study was approved by the Health Research Authority (HRA) and Health and Care Research Wales (HCRW) (reference number: 20/LO/0433).
Informed consent statement: As per the terms of the ethics committee approval, informed consent was not required for the use, for research purposes, of fully anonymised data that had been previously collected during routine clinical care.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: Dataset available on reasonable request from the corresponding author at bshandro@nhs.net.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Benjamin M Shandro, MBBS, MRCP, Research Fellow, Department of Gastroenterology, St George's University Hospitals NHS Foundation Trust, Blackshaw Road, Tooting, London SW17 0QT, United Kingdom. bshandro@nhs.net
Received: April 1, 2021
Peer-review started: April 1, 2021
First decision: June 23, 2021
Revised: July 3, 2021
Accepted: September 19, 2021
Article in press: September 19, 2021
Published online: November 6, 2021
Processing time: 210 Days and 21.6 Hours
Core Tip

Core Tip: Pancreatic exocrine insufficiency (PEI) is associated with chronic pancreatitis, pancreatic cancer, previous upper gastrointestinal surgery and type 2 diabetes. There should be a low threshold for testing for PEI in these patients. Proton pump inhibitor therapy may also be associated with PEI, or a false positive faecal elastase-1 (FE1). Until further evidence becomes available, we recommend repeat testing after a washout period. Steatorrhoea and weight loss were the only symptoms that predicted PEI in our cohort. Therefore, the diagnostic yield of FE1 testing in patients with non-specific presentations, such as bloating, is likely to be low.