Action Plan: Pancreatic Exocrine Insufficiency - Planning and resources

Planning and resources

When challenged with forming a strategy to address unmet needs in PEI, an advisory team of Dietitians, Gastroenterologists, GPs and Pancreatic Surgeons provided the following action points that may be implemented in your clinical centre.
We have also collated a series of supportive resources to help you implement diagnosis and management of PEI in your clinical practice.

Action Plan: Pancreatic Exocrine Insufficiency - Planning and resources

Personalise your action plan

Select the points that are most-relevant to your clinical practice to generate a personalised action plan

For diagnosis of PEI:
  • ‘Think PEI’ if your patient has chronic pancreatitis, pancreatic cancer, cystic fibrosis, diabetes mellitus, inflammatory bowel disease, coeliac disease, diarrhoea predominant irritable bowel syndrome or Crohn’s disease
  • Consider the faecal elastase test in patients presenting with abdominal pain/discomfort, diarrhoea and unintentional weight loss
  • Consider the faecal elastase test in patients presenting with abdominal pain/discomfort, diarrhoea and unintentional weight loss
  • Monitor patients’ nutritional status
  • Provide patient education
  • Explain PEI as a condition that can be tested and treated
For optimal treatment of PEI:
  • Initiate treatment for adults at approximately 50,000 units per meal and 25,000 units per snack
  • Patient review: Schedule review for therapy titration
  • Consider the faecal elastase test in patients presenting with abdominal pain/discomfort, diarrhoea and unintentional weight loss
  • Patient review: Define local multidisciplinary team pathway for therapy review cycle
  • Patient review: Consider following diabetic model of patient review
  • Consider training one dietitian per hospital on PEI (if available, particularly for when PERT is supplied under a Patient Group Direction)

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