Assessment of exocrine pancreatic function in children and adolescents with direct and indirect testing
The exocrine pancreas plays an important role in digestion. Understanding of the physiology and regulation of exocrine function provides insight into disease processes and basis of functional testing. Specifically, exocrine pancreatic insufficiency (EPI) can cause maldigestion and thus a proper asse...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.908542/full |
| _version_ | 1828099276992937984 |
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| author | Puanani Hopson Yamen Smadi Vijay Mehta Samit Patel Devendra Mehta Karoly Horvath |
| author_facet | Puanani Hopson Yamen Smadi Vijay Mehta Samit Patel Devendra Mehta Karoly Horvath |
| author_sort | Puanani Hopson |
| collection | DOAJ |
| description | The exocrine pancreas plays an important role in digestion. Understanding of the physiology and regulation of exocrine function provides insight into disease processes and basis of functional testing. Specifically, exocrine pancreatic insufficiency (EPI) can cause maldigestion and thus a proper assessment of exocrine pancreatic function is important. There are indirect and direct methods for evaluating pancreatic function. Indirect methods are varied and include stool, serum, urine, and breath tests. Fecal elastase is a commonly used indirect test today. Direct methods involve stimulated release of pancreatic fluid that is collected from the duodenum and analyzed for enzyme activity. The most used direct test today is the endoscopic pancreatic function test. Indirect pancreatic function testing is limited in identifying cases of mild to moderate EPI, and as such in these cases, direct testing has higher sensitivity and specificity in diagnosing EPI. This review provides a comprehensive guide to indirect and direct pancreatic function tests as well as an in-depth look at exocrine pancreatic function including anatomy, physiology, and regulatory mechanisms. |
| first_indexed | 2024-04-11T08:13:30Z |
| format | Article |
| id | doaj.art-34d52240be354fa2a288ca641208cbad |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-04-11T08:13:30Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-34d52240be354fa2a288ca641208cbad2022-12-22T04:35:14ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-11-011010.3389/fped.2022.908542908542Assessment of exocrine pancreatic function in children and adolescents with direct and indirect testingPuanani Hopson0Yamen Smadi1Vijay Mehta2Samit Patel3Devendra Mehta4Karoly Horvath5Department of Children Center, Pediatric and Adolescent Medicine, Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United StatesCenter for Digestive Health and Nutrition, Arnold Palmer Hospital for Children, Orlando, FL, United StatesCenter for Digestive Health and Nutrition, Arnold Palmer Hospital for Children, Orlando, FL, United StatesPediatric Gastroenterology & Nutrition of Tampa Bay, Tampa Bay, FL, United StatesCenter for Digestive Health and Nutrition, Arnold Palmer Hospital for Children, Orlando, FL, United StatesCenter for Digestive Health and Nutrition, Arnold Palmer Hospital for Children, Orlando, FL, United StatesThe exocrine pancreas plays an important role in digestion. Understanding of the physiology and regulation of exocrine function provides insight into disease processes and basis of functional testing. Specifically, exocrine pancreatic insufficiency (EPI) can cause maldigestion and thus a proper assessment of exocrine pancreatic function is important. There are indirect and direct methods for evaluating pancreatic function. Indirect methods are varied and include stool, serum, urine, and breath tests. Fecal elastase is a commonly used indirect test today. Direct methods involve stimulated release of pancreatic fluid that is collected from the duodenum and analyzed for enzyme activity. The most used direct test today is the endoscopic pancreatic function test. Indirect pancreatic function testing is limited in identifying cases of mild to moderate EPI, and as such in these cases, direct testing has higher sensitivity and specificity in diagnosing EPI. This review provides a comprehensive guide to indirect and direct pancreatic function tests as well as an in-depth look at exocrine pancreatic function including anatomy, physiology, and regulatory mechanisms.https://www.frontiersin.org/articles/10.3389/fped.2022.908542/fullpancreasexocrine functionacinar cellsduct cellsindirect pancreatic function testdirect pancreatic function test |
| spellingShingle | Puanani Hopson Yamen Smadi Vijay Mehta Samit Patel Devendra Mehta Karoly Horvath Assessment of exocrine pancreatic function in children and adolescents with direct and indirect testing Frontiers in Pediatrics pancreas exocrine function acinar cells duct cells indirect pancreatic function test direct pancreatic function test |
| title | Assessment of exocrine pancreatic function in children and adolescents with direct and indirect testing |
| title_full | Assessment of exocrine pancreatic function in children and adolescents with direct and indirect testing |
| title_fullStr | Assessment of exocrine pancreatic function in children and adolescents with direct and indirect testing |
| title_full_unstemmed | Assessment of exocrine pancreatic function in children and adolescents with direct and indirect testing |
| title_short | Assessment of exocrine pancreatic function in children and adolescents with direct and indirect testing |
| title_sort | assessment of exocrine pancreatic function in children and adolescents with direct and indirect testing |
| topic | pancreas exocrine function acinar cells duct cells indirect pancreatic function test direct pancreatic function test |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.908542/full |
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