Pancreatic Exocrine Insufficiency Guidelines

Australasian guidelines for the management of pancreatic exocrine insufficiency

Starting in March 2014 a working party of committed clinical pancreatologists from The Australasian Pancreatic Club came together to review the literature regarding pancreatic exocrine insufficiency in an impartial way. We believed there were very good reasons why we should devote our time to this project.

Firstly we were aware of differing views in our community, some of which encouraged the use of this treatment when the evidence for benefit was not strong. Secondly, we were aware that some patients were not being prescribed enzymes when their use had clear clinical benefit. It was generally considered that further evidence had been published since the previous Guidelines from our group and we wished to evaluate this literature. Further, It is important to utilise an evidence based approach for prescribing medication, particularly when patients have a lifetime requirement such as for the use of pancreatic enzyme replacement therapy.

A strong view was expressed that there was a need for a complete rewriting of the guidelines rather than a simple update. I was very glad that a group of expert physicians, surgeons, dietitians and paediatricians became involved in this project, all of whom were highly regarded in our community with most having an international reputation of excellence in the field. They all gave their time for no monetary reward and were allocated chapters to appraise the literature and formulate guidelines.

Members recognised that there was likely to be a range of diagnostic difficulties but that it was important to review this now and determine the strength of indication for treatment. A new classification was needed for patients who might need pancreatic enzyme replacement therapy.

For the complete guidelines please click on Australasian guidelines for the management of pancreatic exocrine insufficiency