Fat malabsorption in short bowel syndrome: A review of pathophysiology and management
Nutr Clin Pract. 2024 Apr;39 Suppl 1(Suppl 1):S17-S28. doi: 10.1002/ncp.11119.ABSTRACTFat malabsorption is central to the pathophysiology of short bowel syndrome (SBS). It occurs in patients with insufficient intestinal surface area and/or function to maintain metabolic and growth demands. Rapid intestinal transit and impaired bile acid recycling further contribute to fat malabsorption. A significant portion of patients require parenteral nutrition (PN) for their survival but may develop sepsis and liver dysfunction as a result. Despite advancements in the treatment of SBS, fat malabsorption remains a chronic issue for thi...
Source: Nutrition in Clinical Practice - March 2, 2024 Category: Nutrition Authors: Thomas I Hirsch Sarah Z Wang Scott C Fligor Mikayla Quigley Kathleen M Gura Mark Puder Savas T Tsikis Source Type: research

Fat digestion and absorption: Normal physiology and pathophysiology of malabsorption, including diagnostic testing
This article will give a brief overview of the physiologic process of fat digestion and absorption in healthy individuals as well as review important pathophysiology that can lead to fat malabsorption within the gastrointestinal tract and current diagnostic testing modalities.PMID:38429963 | DOI:10.1002/ncp.11130 (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - March 2, 2024 Category: Nutrition Authors: Endashaw Omer Cristina Chiodi Source Type: research

Fat malabsorption in pancreatic cancer: Pathophysiology and management
Nutr Clin Pract. 2024 Apr;39 Suppl 1:S46-S56. doi: 10.1002/ncp.11129.ABSTRACTExocrine pancreatic insufficiency (EPI) is common in pancreatic ductal adenocarcinoma (PDAC) and may lead to significant nutrition compromise. In the setting of cancer cachexia and gastrointestinal toxicities of cancer treatments, untreated (or undertreated) EPI exacerbates weight loss, sarcopenia, micronutrient deficiencies, and malnutrition. Together, these complications contribute to poor tolerance of oncologic therapies and negatively impact survival. Treatment of EPI in PDAC involves the addition of pancreatic enzyme replacement therapy, with...
Source: Nutrition in Clinical Practice - March 2, 2024 Category: Nutrition Authors: Gretchen Murray Mitchell L Ramsey Phil A Hart Kristen M Roberts Source Type: research

Exocrine pancreatic insufficiency and pancreatic exocrine replacement therapy in clinical practice
Nutr Clin Pract. 2024 Apr;39 Suppl 1:S78-S88. doi: 10.1002/ncp.11124.ABSTRACTExocrine pancreatic insufficiency (EPI) is a complex condition that disrupts normal digestion and absorption. Patients with EPI may suffer from mild to debilitating malabsorption with a constellation of symptoms that can have a significant effect on quality of life and nutrition status. Pancreatic enzyme replacement therapy (PERT) is effective and safe to treat EPI and is the standard of care for this condition. A wide variety and various forms of these products exist, as well as numerous guidelines and recommendations. Obtaining PERT for patients...
Source: Nutrition in Clinical Practice - March 2, 2024 Category: Nutrition Authors: Amy J Berry Amy Bilbo Source Type: research

Exocrine pancreatic insufficiency and fat malabsorption related to pancreatectomy and other gastrointestinal surgery: A narrative review
Nutr Clin Pract. 2024 Apr;39 Suppl 1:S35-S45. doi: 10.1002/ncp.11123.ABSTRACTSurgical resection is the mainstay of treatment for patients with tumors of the pancreas. There are a number of well-recognized complications that account for the significant morbidity associated with the operation, including exocrine pancreatic insufficiency (EPI). Patients with pancreatic cancer commonly have evidence of EPI prior to surgery, and this is exacerbated by an operation, the extent of the insult being dependent on the indication for surgery and the operation performed. There are accumulating data to demonstrate that treatment of EPI ...
Source: Nutrition in Clinical Practice - March 2, 2024 Category: Nutrition Authors: Gareth Morris-Stiff Source Type: research

Fat malabsorption: An underrecognized challenge from pancreatic disease to trauma, critical care, and beyond
Nutr Clin Pract. 2024 Apr;39 Suppl 1:S4-S5. doi: 10.1002/ncp.11128.NO ABSTRACTPMID:38429958 | DOI:10.1002/ncp.11128 (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - March 2, 2024 Category: Nutrition Authors: David C Evans Source Type: research

Cystic fibrosis and fat malabsorption: Pathophysiology of the cystic fibrosis gastrointestinal tract and the impact of highly effective CFTR modulator therapy
Nutr Clin Pract. 2024 Apr;39 Suppl 1:S57-S77. doi: 10.1002/ncp.11122.ABSTRACTCystic fibrosis (CF) is a progressive, genetic, multi-organ disease affecting the respiratory, digestive, endocrine, and reproductive systems. CF can affect any aspect of the gastrointestinal (GI) tract, including the esophagus, stomach, small intestine, colon, pancreas, liver, and gall bladder. GI pathophysiology associated with CF results from CF membrane conductance regulator (CFTR) dysfunction. The majority of people with CF (pwCF) experience exocrine pancreatic insufficiency resulting in malabsorption of nutrients and malnutrition. Additional...
Source: Nutrition in Clinical Practice - March 2, 2024 Category: Nutrition Authors: Catherine M McDonald Elizabeth K Reid John F Pohl Tatiana K Yuzyuk Laura M Padula Kay Vavrina Kimberly Altman Source Type: research

Fat malabsorption in critical illness
Nutr Clin Pract. 2024 Apr;39 Suppl 1:S29-S34. doi: 10.1002/ncp.11121.ABSTRACTMalnutrition in critical illness is common and is associated with significant increases in adverse outcomes. A hypermetabolic state and underfeeding both contribute to the incidence of malnutrition. Malabsorption caused by critical illness is also an important contributor to the development of malnutrition. The early provision of enteral nutrition is associated with improved outcomes. Strategies for nutrition therapy must be informed by the alterations in absorption of macronutrients present in these patients. The following review examines alterat...
Source: Nutrition in Clinical Practice - March 2, 2024 Category: Nutrition Authors: George Kasotakis Colin Whitmore Source Type: research

Fat malabsorption in short bowel syndrome: A review of pathophysiology and management
Nutr Clin Pract. 2024 Apr;39 Suppl 1:S17-S28. doi: 10.1002/ncp.11119.ABSTRACTFat malabsorption is central to the pathophysiology of short bowel syndrome (SBS). It occurs in patients with insufficient intestinal surface area and/or function to maintain metabolic and growth demands. Rapid intestinal transit and impaired bile acid recycling further contribute to fat malabsorption. A significant portion of patients require parenteral nutrition (PN) for their survival but may develop sepsis and liver dysfunction as a result. Despite advancements in the treatment of SBS, fat malabsorption remains a chronic issue for this vulnera...
Source: Nutrition in Clinical Practice - March 2, 2024 Category: Nutrition Authors: Thomas I Hirsch Sarah Z Wang Scott C Fligor Mikayla Quigley Kathleen M Gura Mark Puder Savas T Tsikis Source Type: research

Fat digestion and absorption: Normal physiology and pathophysiology of malabsorption, including diagnostic testing
This article will give a brief overview of the physiologic process of fat digestion and absorption in healthy individuals as well as review important pathophysiology that can lead to fat malabsorption within the gastrointestinal tract and current diagnostic testing modalities.PMID:38429963 | DOI:10.1002/ncp.11130 (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - March 2, 2024 Category: Nutrition Authors: Endashaw Omer Cristina Chiodi Source Type: research

Fat malabsorption in pancreatic cancer: Pathophysiology and management
Nutr Clin Pract. 2024 Apr;39 Suppl 1:S46-S56. doi: 10.1002/ncp.11129.ABSTRACTExocrine pancreatic insufficiency (EPI) is common in pancreatic ductal adenocarcinoma (PDAC) and may lead to significant nutrition compromise. In the setting of cancer cachexia and gastrointestinal toxicities of cancer treatments, untreated (or undertreated) EPI exacerbates weight loss, sarcopenia, micronutrient deficiencies, and malnutrition. Together, these complications contribute to poor tolerance of oncologic therapies and negatively impact survival. Treatment of EPI in PDAC involves the addition of pancreatic enzyme replacement therapy, with...
Source: Nutrition in Clinical Practice - March 2, 2024 Category: Nutrition Authors: Gretchen Murray Mitchell L Ramsey Phil A Hart Kristen M Roberts Source Type: research

Exocrine pancreatic insufficiency and pancreatic exocrine replacement therapy in clinical practice
Nutr Clin Pract. 2024 Apr;39 Suppl 1:S78-S88. doi: 10.1002/ncp.11124.ABSTRACTExocrine pancreatic insufficiency (EPI) is a complex condition that disrupts normal digestion and absorption. Patients with EPI may suffer from mild to debilitating malabsorption with a constellation of symptoms that can have a significant effect on quality of life and nutrition status. Pancreatic enzyme replacement therapy (PERT) is effective and safe to treat EPI and is the standard of care for this condition. A wide variety and various forms of these products exist, as well as numerous guidelines and recommendations. Obtaining PERT for patients...
Source: Nutrition in Clinical Practice - March 2, 2024 Category: Nutrition Authors: Amy J Berry Amy Bilbo Source Type: research

Exocrine pancreatic insufficiency and fat malabsorption related to pancreatectomy and other gastrointestinal surgery: A narrative review
Nutr Clin Pract. 2024 Apr;39 Suppl 1:S35-S45. doi: 10.1002/ncp.11123.ABSTRACTSurgical resection is the mainstay of treatment for patients with tumors of the pancreas. There are a number of well-recognized complications that account for the significant morbidity associated with the operation, including exocrine pancreatic insufficiency (EPI). Patients with pancreatic cancer commonly have evidence of EPI prior to surgery, and this is exacerbated by an operation, the extent of the insult being dependent on the indication for surgery and the operation performed. There are accumulating data to demonstrate that treatment of EPI ...
Source: Nutrition in Clinical Practice - March 2, 2024 Category: Nutrition Authors: Gareth Morris-Stiff Source Type: research

Fat malabsorption: An underrecognized challenge from pancreatic disease to trauma, critical care, and beyond
Nutr Clin Pract. 2024 Apr;39 Suppl 1:S4-S5. doi: 10.1002/ncp.11128.NO ABSTRACTPMID:38429958 | DOI:10.1002/ncp.11128 (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - March 2, 2024 Category: Nutrition Authors: David C Evans Source Type: research

Cystic fibrosis and fat malabsorption: Pathophysiology of the cystic fibrosis gastrointestinal tract and the impact of highly effective CFTR modulator therapy
Nutr Clin Pract. 2024 Apr;39 Suppl 1:S57-S77. doi: 10.1002/ncp.11122.ABSTRACTCystic fibrosis (CF) is a progressive, genetic, multi-organ disease affecting the respiratory, digestive, endocrine, and reproductive systems. CF can affect any aspect of the gastrointestinal (GI) tract, including the esophagus, stomach, small intestine, colon, pancreas, liver, and gall bladder. GI pathophysiology associated with CF results from CF membrane conductance regulator (CFTR) dysfunction. The majority of people with CF (pwCF) experience exocrine pancreatic insufficiency resulting in malabsorption of nutrients and malnutrition. Additional...
Source: Nutrition in Clinical Practice - March 2, 2024 Category: Nutrition Authors: Catherine M McDonald Elizabeth K Reid John F Pohl Tatiana K Yuzyuk Laura M Padula Kay Vavrina Kimberly Altman Source Type: research