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Friday, January 21, 2022

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    Thoughts of pancreatic cancer trouble reader with EPI

    Dear Dr. Roach: Recently I was diagnosed with exocrine pancreatic insufficiency after symptoms of unexpected and sustained diarrhea for three months. I was also diagnosed with NAFLD (nonalcoholic fatty liver disease) last November. A year ago, I first noticed slight weight loss (5 pounds) and decreased energy. I am 69 years old, 6 foot, 2 inches tall and currently weigh 173. I underwent a colonoscopy (unremarkable) and a stool exam that showed below normal elastase (189 vs. 200 being the low end of normal). I will begin a drug therapy next week, using pancreatic enzymes, but I worry about pancreatic cancer. Recently I had two friends die of pancreatic cancer. I just can’t seem to get past the worry that I may have it. What do you suggest?


    Dear D.C.: The pancreas has two main jobs: to make insulin and other hormones (this is the endocrine function, from the Greek roots meaning “secretion within”), and to make digestive enzymes (exocrine, meaning “secretion outside”). The pancreatic digestive enzymes are critical for proper absorption of food, especially the fats we eat. Without pancreatic enzymes, food cannot be digested, and people will notice diarrhea, often with visible fat; abdominal discomfort; and weight loss. It takes near-complete insufficiency of the pancreas to develop severe symptoms.

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