NMR spectrometric stool fat analysis--a new technique for quantifying steatorrhea and establishing the indication for enzyme replacement in chronic pancreatitis.
In 93 patients with known exocrine pancreatic function (secretin-pancreozymin test), NMR spectrometry and chloroform-methanol extraction of quantitatively collected, homogenized and lyophilized stools provided significantly correlated results with respect to stool fat concentration (r = 0.872) and total stool fat excretion/day (r = 0.983). In 83% of 24 patients with total stool fat excretion/day of more than 15 g (chloroform-methanol extraction), the indication for enzyme replacement was also established by stool fat concentrations of more than 35% determined by NMR spectrometry, irrespective of whether stool fat was measured in total stools or in 3 consecutive unhomogenized samples. In the remaining (17%) patients total stool fat excretion/day was only slightly elevated (16-21 g). Interestingly, in only 58% of patients actually needing enzyme replacement, did the secretin-pancreozymin test reveal a reduction of stimulated enzyme secretion to below 15% of the lower normal limit. The results indicate that NMR spectrometry of lyophilized samples of 3 consecutive unhomogenized stools is suitable for stool fat quantitation and for establishing the indication for enzyme replacement in chronic pancreatitis.
Schneider
M U
MU
Demling
L
L
Domschke
S
S
Heptner
G
G
Merkel
I
I
Domschke
W
W
D000681:Amylases / Q000032:analysis; D002446:Celiac Disease / Q000473:pathology*; D002766:Cholecystokinin; D002918:Chymotrypsin / Q000032:analysis; D004041:Dietary Fats / Q000032:analysis; D005243:Feces / Q000032:analysis*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D010179:Pancreas / Q000201:enzymology*; D010195:Pancreatitis / Q000628:therapy*; D012633:Secretin; D014357:Trypsin / Q000032:analysis
D004041:Dietary Fats; D012633:Secretin; D002766:Cholecystokinin; D000681:Amylases; D002918:Chymotrypsin; D014357:Trypsin