Efficacy and safety of pancreatic enzyme replacement therapy in pancreatic exocrine insufficiency: a systematic review protocol.

REVIEW QUESTION / OBJECTIVE  Does pancreatic enzyme replacement therapy improve nutritional status such as body mass index and fat-soluble vitamins associated with improved fat absorption and better control of gastrointestinal symptoms associated with fat malabsorption in patients with pancreatic exocrine insufficiency? Does the timing of pancreatic enzyme administration and adjuvant therapy with proton pump inhibitor influence the effectiveness of pancreatic enzyme replacement therapy for patients with pancreatic exocrine insufficiency? The objectives of this review are to identify the effect of pancreatic enzyme replacement therapy on: Fat absorption in patients with pancreatic exocrine insufficiency Nutritional impact such as weight change and nutritional markers Improvement in gastrointestinal symptoms Treatment related adverse events in patients with pancreatic exocrine insufficiency. In addition to these, the timing of pancreatic enzyme administration and adjuvant therapy with proton pump inhibitors will also be investigated for its effectiveness in pancreatic enzyme replacement therapy. INCLUSION CRITERIA Types of participants This review will consider studies that include all patients with pancreatic exocrine insufficiency, including patients with chronic pancreatitis, pancreatic cancer, and a history of pancreatic surgical resection and cystic fibrosis in acute and community settings. Studies on patients with celiac disease, diabetes mellitus, human immunodeficiency virus, irritable bowel syndrome, post gastric and bowel resections will not be included as the use of pancreatic enzyme replacement therapy in these populations has not been fully accepted. Studies on patients of any age will be included. Types of intervention(s)/phenomena of interest This review will consider studies that evaluate pancreatic enzyme replacement therapy without TRUNCATED AT 250 WORDS