Introduction
The pancreas has both endocrine and exocrine functions.
The pancreas has both endocrine and exocrine functions. The endocrine pancreas produces hormones such as insulin and glucagon. The exocrine pancreas produces digestive enzymes that enter the small intestine and help digest food. Pancreatic enzyme products contain lipase, protease, and amylase, which help digest fat, protein, and carbohydrates. DailyMed’s CREON label identifies pancrelipase products as containing lipases, proteases, and amylases. (DailyMed) When exocrine pancreatic function is impaired, nutrients are not broken down effectively. Fat malabsorption is especially clinically visible. The client may develop steatorrhea, which often appears as bulky, oily, greasy, foul-smelling stool that may float. The client may also experience bloating, cramping, diarrhea, flatulence, poor appetite, weight loss, fatigue, and signs of malnutrition. EPI may occur with chronic pancreatitis, cystic fibrosis, pancreatic cancer, pancreatic surgery, or other pancreatic and gastrointestinal disorders. NIDDK notes that PERT can improve symptoms and help clients get enough nutrients from food and drink. (NIDDK) RN clinical reasoning point: If a client has ongoing steatorrhea despite PERT, the RN should not immediately conclude that the medication is ineffective. The RN should assess timing, dose adherence,...
