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Covers the pancreas’ digestive and endocrine roles, digestive enzymes by food group, and the process of digestion. Defines PEI, explains causes, incidence in operable and inoperable pancreatic cancer, key signs and symptoms, and diagnostic considerations. Details how PERT supports digestion, who benefits, practical tips and considerations, differential diagnosis, and includes a case study and summary.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/pancreatic-enzyme-insufficiency-pei-and-pancreatic-enzyme-replacement-therapy-pert-overview-and-learning-outcomes/508499/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/pancreatic-enzyme-insufficiency-pei-and-pancreatic-enzyme-replacement-therapy-pert-overview-and-learning-outcomes/508499.png","ImageObject",300,407,{"name":92,"@type":93},"Jake","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-09","2026-10-05",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the definition of pancreatic enzyme insufficiency (PEI)?","Question",{"text":112,"@type":113},"PEI is defined as a reduction of pancreatic exocrine activity in the intestine at a level that prevents normal digestion.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What are the primary and secondary causes of PEI?",{"text":117,"@type":113},"Primary causes include obstruction of the pancreatic duct, damage to the exocrine pancreas, loss of pancreatic tissue from surgery, pancreatitis, and cystic fibrosis. Secondary causes include lack of pancreatic stimulation such as changes in intestinal pH after gastric/duodenal resection, asynchrony after bypass, and abnormal CCK and secretin release.",{"name":119,"@type":110,"acceptedAnswer":120},"How does PERT help, and who benefits from it?",{"text":121,"@type":113},"PERT provides pancreatic enzymes to support effective digestion. It benefits groups with PEI, including those with pancreatic cancer and other causes of pancreatic exocrine insufficiency.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},508499,1791347996,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962084928904,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Pancreatic enzyme insufficiency (PEI) and pancreatic enzyme replacement therapy (PERT)  \nLauren Roberts  \nHPB/UGI Lead Oncology Dietitian  \nThe Clatterbridge Cancer Centre (Wirral & Liverpool)  \nOverview and learning outcomes  \n􀁘 Role of the pancreas and role in digestion  \n􀁘 Pancreatic enzyme insufficiency (PEI) Causes  \nSigns and symptoms Diagnosing PEI Impact of PEI  \n􀁘 Pancreatic enzyme replacement therapy (PERT)  \nGroups that benefit from PERT Impact of PERT  \nPancreatic replacement therapy Use tips and considerations with PERT PERT and enteral feeding Differential diagnosis  \n􀁘 Case study  \n􀁘 Summary  \nPoll one  \nWhat are the key roles of the pancreas?  \nAnswer all that apply…  \nA) Detoxifying  \nB) Absorbing nutrients  \nC) Release of gastric juices containing enzymes to help break down food into small particles for absorption by the body  \nD) Releases insulin and glucagon to help maintain blood sugar levels  \nDigestive process  \nDigestive enzymes  \nKeller and Layer ( 2005) Imrie , C.W et al. ,(2010)  \n\n| Food group | Saliva | Gastric | Pancreatic | Jejunal /Ileal |\n| --- | --- | --- | --- | --- |\n| Carbohydrate | Salivary amylase | Gastric amylase | Amylase | Sucrase, Maltase, Lactase, Isomaltase |\n| Fat | Salivary lipase | Gastric lipase | Lipase , Steapsin | Intestinal lipase |\n| Protein |  | Pepsin, Rennin, Gelatinase | Trypsin, Elastase, Chymotrypsin, Carboxypeptidase | Brush Border Peptidases |\n\nDigestion and the role of the pancreas  \nEndocrine function  \n(maintenance of blood glucose levels)  \nThroughout the pancreas  \nSecretes from the islets of langerhans • Beta cells –insulin  \n• Alpha cells –glucagon  \n• Delta Cells –Somatostatin  \n• Pancreatic polypeptide  \nExocrine function  \n(secretion of digestive enzymes)  \nAcinar cells –digestive enzymes Ductal cells –bicarbonate  \nOptimal pH 6.5 for effective functioning  \nDigestive enzymes  \nCarbohydrates  \nAmylase  \nDisaccharidesand glucose  \nFats  \nLipase  \nFatty acids  \nProtein  \nProtease  \nPeptides and amino acids  \nPancreatic exocrine insuffiency/ PEI  \nDefinition:  \n‘PEI is defined as a reduction of pancreatic exocrine activity in the intestine at a level that prevents normal digestion.’  \nPhillips et al. , (2021)  \nIncidence of PEI  \nInoperable pancreatic cancer –50-100%  \nOperable pancreatic cancer-  \n• 12% following central pancreatectomy  \n• 20% following distal pancreatectomy  \n• 20-45% pre-op for head of pancreas  \n• 70-98% following pancreatico-duodenectomy  \nBartel et al.,(2015) Philips et al. ,(2015) Sabateret et al. ,(2016)  \nCauses of pancreatic exocrine insufficiency  \n\n| Primary causes (lack of healthy tissue) | Secondary causes (lack of pancreatic stimulation) |\n| --- | --- |\n| Obstruction of pancreatic duct by tumour | Changes in intestinal pH following gastric/duodenal resection |\n| Damage to the exocrine pancreas | Asynchrony in the delivery of pancreatic juice following a bypass of the bile duct, pancreas, stomach or duodenum |\n| Loss of pancreatic tissue (surgery) | Abnormal CCK & secretin release |\n| Pancreatitis |  |\n| Cystic fibrosis |  |\n\nKeller and  \nLayer,(2005)","cbCaio1N8SDiVlAB","https://ap.wps.com/l/cbCaio1N8SDiVlAB","pdf",1027160,37,"English","# Overview and learning outcomes\n## Role of the pancreas and role in digestion\n## Pancreatic enzyme insufficiency (PEI)\n## Pancreatic enzyme replacement therapy (PERT)\n## Differential diagnosis\n## Case study\n## Summary","[{\"question\":\"What is the definition of pancreatic enzyme insufficiency (PEI)?\",\"answer\":\"PEI is defined as a reduction of pancreatic exocrine activity in the intestine at a level that prevents normal digestion.\"},{\"question\":\"What are the primary and secondary causes of PEI?\",\"answer\":\"Primary causes include obstruction of the pancreatic duct, damage to the exocrine pancreas, loss of pancreatic tissue from surgery, pancreatitis, and cystic fibrosis. Secondary causes include lack of pancreatic stimulation such as changes in intestinal pH after gastric/duodenal resection, asynchrony after bypass, and abnormal CCK and secretin release.\"},{\"question\":\"How does PERT help, and who benefits from it?\",\"answer\":\"PERT provides pancreatic enzymes to support effective digestion. It benefits groups with PEI, including those with pancreatic cancer and other causes of pancreatic exocrine insufficiency.\"}]","Pancreatic Enzyme Insufficiency (PEI) and Pancreatic Enzyme Replacement Therapy (PERT) - Overview and Learning Outcomes | PDF",1791224967,93]