An analysis on fat digestion in the upper small intestine after intragastric infusion of a test meal in patients with exocrine pancreatic insufficiency

Abstract

To clarify the mechanism of the fat maldigestion in 9 patients with exocrine pancreatic insufficiency, lipase activities, pH, and micellar lipids in the upper small intestinal contents were studied.
The upper small intestinal pH was slightly less in patients with exocrine pancreatic insufficiency than in healthy controls. Lipase activities and micellar lipids were significantly reduced in patients with exocrine pancreatic insufficiency compared with in healthy controls. There was a significant correlation between serum cholesterol and micellar cholesterol concentrations.
The results suggest that there is maldigestive state in the digestion-absorption process in patients with exocrine pancreatic insufficiency due to insufficiency of lipase secretion and that insufficiency of lipase secretion disturbs hydrolysis of triglyceride and prevends micelle formation and leads to reduced uptake of cholesterol into micellar phase and it is reflected in serum cholesterol.