alpha-chymotrypsin and Postgastrectomy-Syndromes

In 96 consecutive patients who underwent a 72-h faecal fat determination because of suspected nutrient malassimilation (maldigestion and/or malabsorption) faecal chymotrypsin (F-Chym) was estimated with a commercial photometric test (Monotest Chymotrypsin), comparing F-Chym concentrations in the first 24-h stool with the total 72-h F-Chym output. In the first 24-h faeces, the F-Chym concentration, calculated as a mean of three random samples, did not significantly differ from a single value obtained after homogenization. In known pancreatic disease, a F-Chym concentration less than 3.0 U/g wet faeces distinguished well between steatorrhoic patients (n = 12) and nonsteatorrhoic (n = 13) (positive predictive value (PV), 91%; negative PV, 86%) but was less suitable as a screening test for pancreatic steatorrhoea in the unselected patient group (positive PV, 61%; negative PV, 98%). Although the estimation of 72-h F-Chym output could differentiate between various subgroups of patients to a certain extent, the positive PV for discovery of pancreatic steatorrhoea in a single patient was low. Four patients had excessively high F-Chym output and increased bile acid excretion after ileal resection (n = 3) and radiation ileitis (n = 1), respectively, possibly indicating the removal of an inhibitory mechanism of pancreatic and biliary secretion in these conditions.

Topics: Adult; Celiac Disease; Chymotrypsin; Exocrine Pancreatic Insufficiency; Feces; Female; Humans; Intestinal Diseases; Male; Middle Aged; Postgastrectomy Syndromes; Predictive Value of Tests; Sensitivity and Specificity; Weight Loss

Topics: Adult; Chymotrypsin; Crohn Disease; Feces; Gastrointestinal Diseases; Humans; In Vitro Techniques; Pancreatic Diseases; Postgastrectomy Syndromes; Trypsin

Topics: Chymotrypsin; Gastrectomy; Hematologic Tests; Humans; Postgastrectomy Syndromes; Research