Nutritional Status among Patients with Pancreatic Disease and Indication for Pancreatic Enzyme Replacement Therapy in Colombo South Teaching Hospital, Sri Lanka

Rationale: Pancreatic enzyme replacement therapy (PERT) is the mainstay of treatment for Pancreatic exocrine insufficiency (PEI), a consequence of chronic pancreatitis and pancreatic resection for pancreatic tumours. Untreated PEI causes maldigestion and malabsorption of nutrients, eventually leading to malnutrition. This study assessed the nutritional status of PERT-indicated patients in terms of disease-related weight loss, body composition analysis, and Vitamin D level. Methods: A descriptive cross-sectional study was done on all eligible patients who attended the professorial surgical clinic of Colombo South Teaching Hospital from August 2021 to February 2022. Trained doctors performed data collection using an interviewer-administered questionnaire, anthropometrics, and body composition analysis. R software was used to produce descriptive statistics; mean ±SD for numerical, and counts and percentages for categorical variables. Welch’s two-sample t-test was used to elicit statistical significance between the means of two independent subgroups. Results: The study included 44 patients with a mean age of 47 (±13) years and male predominance (79.5%). PERT was ever consumed by 15 (34.1%) and the majority 14 (93.3%) were compliant. Patients ever on PERT had a lower mean BMI, body fat percentage, muscle mass, and bone mass, than those who were never on PERT (p ≤0.05). The differences between the means of weight loss and vitamin D levels of the two groups were not significant (p >0.05). Conclusion: Patients who ever had PERT had a worse nutritional status than those who never had PERT. This may be due to prioritizing PERT prescription on patients with existing malnutrition, owing to the lack of an objective method to diagnose PEI, and the limited PERT availability in this setting. A prospective study with more participants may elucidate more on this issue. Disclosure of Interest: None declared