Evaluation of pancreatic exocrine function in patients with Crohn’s disease

Abstract

Background Pancreatic dysfunction has been reported as a manifestation of Crohn’s disease (CD). Our study aimed to correlate exocrine pancreatic function in patients with CD with the site and extent of the disease, length of diagnosis, activity indices, complications and steatorrhoea. Methods After deep cannulation during ERCP and i.v. secretin injection (I U kg − 1 ), pure pancreatic juice (PPJ) was obtained over two 5 min periods from 15 CD patients without any history of alcohol abuse, diabetes or other chronic disease and who were not taking immunosuppressant therapy. Four patients undergoing ERCP for investigation of cholestasis were used as controls. Results No differences were found between the two groups, but individual observations could be made. Bicarbonate secretion was decreased in patients with a long history of CD. The lipase content of PPJ was decreased in the second 5 min period if patients were classified according to the CD activity index, while the volume of stimulated juice was decreased if patients were classified according to the simple index. Lower pancreatic amylase and lipase secretions were found in patients with extensive CD. There was no relationship between PPJ parameters and nutritional status, complications or faecal fat loss. Discussion If CD is longstanding, extensive or associated with a high inflammatory activity, exocrine pancreatic function is impaired. These changes may have little clinical relevance, otherwise the use of pancreatic enzymes would be necessary in patients with CD and intractable diarrhoea.