What may result with high dose pancreatic enzyme therapy?

What may result with high dose pancreatic enzyme therapy?

• A. Ulcers
• B. Gallstones
• C. Pancreatitis
• D. Fibrosing colonopathy

Answer: (D)

High-dose pancreatic enzyme therapy can lead to fibrosing colonopathy. When patients, especially those with pancreatic exocrine insufficiency such as in cystic fibrosis, receive very large doses of pancreatic enzymes (lipase), the enzymes in the colon may promote an inflammatory-fibrotic process in the colonic wall. This results in thickening of the submucosa and fibrosis that can narrow the colon and cause symptoms like abdominal pain, distension, and potential obstruction. Modern dosing and enteric-coated formulations reduce this risk, but it is a known potential complication when enzyme doses are excessive. The other options aren’t typical outcomes of high-dose enzyme therapy (ulcers, gallstones, pancreatitis), so fibrosing colonopathy best fits the association.

High-dose pancreatic enzyme therapy can lead to fibrosing colonopathy. When patients, especially those with pancreatic exocrine insufficiency such as in cystic fibrosis, receive very large doses of pancreatic enzymes (lipase), the enzymes in the colon may promote an inflammatory-fibrotic process in the colonic wall. This results in thickening of the submucosa and fibrosis that can narrow the colon and cause symptoms like abdominal pain, distension, and potential obstruction. Modern dosing and enteric-coated formulations reduce this risk, but it is a known potential complication when enzyme doses are excessive. The other options aren’t typical outcomes of high-dose enzyme therapy (ulcers, gallstones, pancreatitis), so fibrosing colonopathy best fits the association.