Is pancreatic insufficiency curable?

Pancreatic insufficiency is no longer curable. The course and severity of the symptoms can be improved by a good treatment of the symptoms with appropriate medication containing digestive enzymes, an adapted diet with the aim of weight gain and a sufficient energy supply. However, the symptoms will not disappear completely.

A complete renunciation of alcohol (as a frequent cause of pancreatic insufficiency) and nicotine also has a positive effect on the further course of the disease. The diet in pancreatic insufficiency should aim to alleviate symptoms and ensure a good nutritional status. An improvement in the absorption of nutrients is achieved by the substitution (= replacement of missing substances) of digestive enzymes in the form of medication.

According to the guidelines, pancreatin is recommended for significant complaints such as steatorrhea (= fatty stools), gastrointestinal complaints, meteorism and malabsorption. Taking this medication up to 6 times a day can lead to a reduction in symptoms. To maintain a robust bone and skeletal system, vitamin D should be administered in the form of tablets.

Vitamin D plays a major role in building and maintaining the skeleton and can only be insufficiently absorbed by the body in pancreatic insufficiency. If the symptoms are improved by adequate medication, the individual components of the food are better absorbed. This also applies to carbohydrates.

If the diabetic metabolism is already in a state, it is important to closely monitor blood sugar levels and to initiate an appropriate insulin therapy. In general, it is important to reduce the poor intake of the individual food components and to ingest a sufficiently high amount of food orally. However, this does not mean avoiding fats or a limited intake of carbohydrates.

A better option is to adjust the medication accordingly. Only in difficult exceptional cases, for example in the case of fatty stools that cannot be treated, should the intake of fats be reduced; in return, one must pay attention to an increase in proteins and carbohydrates in the diet. In cases of very severe pancreatic insufficiency, it may be necessary to supplement the diet with parenterally (= “artificial nutrition”) supplied additives.

To this end, there is the possibility of consuming so-called high-calorie food. These are drinks that contain many kilocalories in a relatively small volume. In addition, there is the possibility of adding further calories in liquid form intravenously via stomach tubes or PEG ́s (percutaneous endoscopic gastrostomy).

Alcohol abuse is one of the leading causes of pancreatic insufficiency in Germany. Excessive alcohol consumption leads to a short-term or permanent inflammation of the pancreas in some people and can thus damage it. The progression of a pancreatic insufficiency caused by this can usually only be managed by completely abstaining from alcohol.

All other forms of therapy only serve to improve the symptoms. Further alcohol consumption in the presence of pancreatic insufficiency can have serious consequences. Large amounts of alcohol can severely impair digestion.

This is dangerous in the long term for people with an insufficiency of the pancreas, as existing problems of digestion are thus intensified. If the patient has already developed diabetes, alcohol consumption can be life-threatening. This is because alcohol reduces the blood sugar level and, if not eaten at the same time, can cause hypoglycaemia with symptoms such as sweating, trembling, concentration problems and loss of consciousness and can even lead to death. Since many people affected by pancreatic insufficiency are alcohol-dependent, a complete abstinence from alcohol must be observed – just one beer can lead to a relapse!