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The Role of the Gut Microbiome in Cardiovascular Disease
Published in Stephen T. Sinatra, Mark C. Houston, Nutritional and Integrative Strategies in Cardiovascular Medicine, 2022
Pancreatic Elastase Treatment: Smoking cessationReduced alcohol consumptionSmall frequent mealsReplacement of fat-soluble vitaminsSupplemental lipase or pancreatic enzymes (plant-based digestive enzymes may not be strong enough for EPI)Prescription strength enzymes: CREON®, ZENPEP®, and others.
Managing Pain in the Presence of Autoimmune Disease
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
The gut is a huge central mechanism in immune system dysregulation and the associated pain. Information received by the use of a digestive stool analysis is so helpful, and most of it is typically unavailable through hospital or local lab testing (Figure 6.9). Pancreatic elastase levels inform us if the pancreas is still able to produce this important enzyme. It can drop for a variety of reasons including if the pancreas is having to work hard to make higher than ideal levels of insulin due to insulin resistance.102 Or perhaps even fasting insulin levels have dropped below ideal on their way from pre-diabetes to full-blown diabetes. As we discussed earlier, when the important hormone triad of cortisol, thyroid, and insulin/blood sugar is disrupted, insulin resistance will be the result. As cortisol and thyroid are correcting, the insulin resistance and pancreatic elastase production can self-correct.
Metabolic Approaches to the Treatment of Back Pain
Published in Kohlstadt Ingrid, Cintron Kenneth, Metabolic Therapies in Orthopedics, Second Edition, 2018
Carrie Diulus, Patrick Hanaway
D = Digestive function Gastric acidity: Hypochlorhydria is common when sympathetic overdrive is occurring. Evaluate with Heidelberg pH capsule.Pancreatic function: Decreased vagal tone and villous atrophy will both decrease pancreatic excretion of digestive enzymes (proteases, lipases, amylases). Evaluate with fecal pancreatic elastase.
Characterization of gut microbiota composition and functions in patients with chronic alcohol overconsumption
Published in Gut Microbes, 2019
Steinar Traae Bjørkhaug, Håvard Aanes, Sudan Prasad Neupane, Jørgen G. Bramness, Stine Malvik, Christine Henriksen, Viggo Skar, Asle W. Medhus, Jørgen Valeur
We applied “Time line follow-back”31 to assess the amount of alcohol intake. The instrument was used to capture daily alcohol use (unit for unit) for a period between 2 and 4 previous weeks. These data were applied as a basis for alcohol use over time, in accordance with the patients’ recollection of alcohol intake prior to this 2–4 week period. The patients’ nutritional status was evaluated using the screening tool Mini Nutritional Assessment (MNA)32 and anthropometric measures (height, weight). Muscle mass was assessed by a Tanita BC-418 Segmental Body Composition Analyzer (TANITA Corporation, Tokyo, Japan). As a marker for muscle function, we measured the participants’ handgrip strength by a dynamometer (Kern MAP, Kern & Sohn, Balingen, Germany). Biochemical markers included vitamins A, B1, B9, B12, C and D, hepatic and renal function tests, hematological status, iron levels, and electrolytes, and were measured as part of the hospital’s routine analyses. Fecal levels of elastase were measured using a commercial kit (Human Pancreatic Elastase ELISA BS 86–01, Bioserv Diagnostics, Rostock, Germany). Based on elastase levels, patients were classified as having a normal exocrine pancreatic function (>200 μg elastase/g feces), moderate exocrine pancreatic insufficiency (100–200 μg elastase/g feces), or severe exocrine pancreatic insufficiency (<100 μg elastase/g feces).
Supplementation of Vitamin D Deficiency in Patients with Neuroendocrine Tumors Using Over-the-Counter Vitamin D3 Preparations
Published in Nutrition and Cancer, 2018
Helen L. Robbins, Megan Symington, Barbara Mosterman, Josie Goodby, Louise Davies, Georgios K. Dimitriadis, Gregory Kaltsas, Harpal S. Randeva, Martin O. Weickert
Routine biochemical markers were processed and analyzed in the certified biochemistry laboratories at University Hospitals Coventry & Warwickshire NHS Trust. Vit-D was measured utilizing electrochemiluminescence (ECLIA, Cobas e411, Roche Diagnostics). Faecal elastase-1 concentration in stools was determined using ELISA (ScheBo Pancreatic Elastase-1 Stool Test). The human faecal elastase-1 antibody is immunologically specific and is not affected by enzyme replacement therapies. Plasma gut hormone profiles were sampled after at least 10 h of overnight fast, with analysis utilizing radioimmunoassay at Hammersmith Hospital, London. Samples for measurement of 5-HIAA in 24-h urine were collected following restriction for factors known to cause falsely high or low measurements of urinary 5-H1AA, with analysis performed using HPLC at Heartlands Hospital, Birmingham.
Importance of Pancreatic Enzyme Replacement Therapy after Surgery of Cancer of the Esophagus or the Esophagogastric Junction
Published in Nutrition and Cancer, 2018
Thomas Kiefer, Dorothea Krahl, Kathrin Osthoff, Peter Thuss-Patience, Jörg Bunse, Ulrich Adam, Marc H. Jansen, Rudolf Ott, Robert Pfitzmann, Matthias Pross, Thomas Kohlmann, Georg Daeschlein, Hermann Buhlert, Heinz Völler, Carsten Hirt
This study shows that steatorrhea is a common problem among patients after surgery of cancer of the esophagus or the esophagogastric junction. Beside measures like nutritional counselling initiation or dose escalation of PERT can lead to weight gain and therefore to an improved functional outcome and improved quality of life. Prospective studies in patients after surgery for esophageal cancer are needed to confirm the impact of PERT in this patient population and to define variables in addition to steatorrhea which allow the identification of patients who benefit most from this enzyme replacement therapy. In addition to anamnestic steatorrhea the quantification of human pancreatic elastase 1 in faeces should be performed for the diagnosis of pancreatic exocrine insufficiency.