Pancreatic Enzyme Replacement Therapy: Background, Indications, and Pitfalls

Authors

  • John G. Lieb II MD University of Florida, Gainesville,, FL Author

DOI:

https://doi.org/10.69734/gqsbgc07

Keywords:

Digestive Capacity, Exocrine Insufficiency, steatorrhea, pancreatic enzyme replacement, PERT, PEP, chronic pancreatitis, malabsorption, maldigestion, bloating, flatulence, diarrhea, SIBO, Bacterial Overgrowth, Failure to Thrive, Wasting, Pancreatic atrophy, Fatty pancreas, Pancreatic Cancer, Pancreatic surgery, Practical, Clinical, History of PERT or PEP

Abstract

This review outlines the history, physiology, clinical circumstances, pharmacology, pitfalls and proper implementation of exogenous pancreatic enzyme replacement therapy (PERT).

Humanity has used PERT for hundreds of years--but in the last 30-50 years with much improved precision.  Some topics that will be reviewed here include the complex diagnosis, prevalence, and long-term complications of Exocrine Pancreatic Insufficiency (EPI) and resultant dysfunction in Digestive Capacity (DC).  The indications, efficacy, and safety of PERT in Exocrine Pancreatic Insufficiency (EPI).    Optimizing PERT is not as easy as it seems.  Many practical tips for PERT optimization are outlined for the reader.

References

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Published

2025-03-31 — Updated on 2025-05-21

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How to Cite

Lieb II, john. (2025). Pancreatic Enzyme Replacement Therapy: Background, Indications, and Pitfalls. SMART-MD Journal of Precision Medicine, 2(1), e85-e92. https://doi.org/10.69734/gqsbgc07 (Original work published 2025)