What complication can result with high dose pancreatic enzyme usage?

What complication can result with high dose pancreatic enzyme usage?

• A. Fibrosing colonopathy with strictures of the ascending colon
• B. Diabetes mellitus
• C. Pancreatic cancer
• D. Allergic reaction

Answer: (A)

High-dose pancreatic enzyme replacement therapy can lead to fibrosing colonopathy, a fibrotic thickening and narrowing of the colon, most often in the ascending segment. When enzymes—especially lipase—are given in very large amounts, they can irritate the colonic mucosa and stimulate fibroblasts to lay down collagen, producing strictures. Clinically, this can present as abdominal pain, distention, vomiting, or signs of bowel obstruction in someone receiving high enzyme doses. Treatment focuses on reducing the enzyme dose and closely monitoring for symptoms, rather than suggesting it will cause diabetes or cancer. Allergic reactions to the enzyme product can occur but are not the classic complication associated with high-dose use.

High-dose pancreatic enzyme replacement therapy can lead to fibrosing colonopathy, a fibrotic thickening and narrowing of the colon, most often in the ascending segment. When enzymes—especially lipase—are given in very large amounts, they can irritate the colonic mucosa and stimulate fibroblasts to lay down collagen, producing strictures. Clinically, this can present as abdominal pain, distention, vomiting, or signs of bowel obstruction in someone receiving high enzyme doses. Treatment focuses on reducing the enzyme dose and closely monitoring for symptoms, rather than suggesting it will cause diabetes or cancer. Allergic reactions to the enzyme product can occur but are not the classic complication associated with high-dose use.