Treatment of pancreatic insufficiency involves resolving the underlying condition, where possible, to prevent or minimize further pancreatic damage and manage the symptoms.
Those affected may be given oral preparations of pancreatic enzymes as a supplement, a treatment known as pancreatic enzyme replacement therapy or PERT, to make up for decreased enzyme production and to aid digestion. The primary purpose of this therapy is to ensure proper nutritional status. The therapy involves taking porcine (pig)-derived pancreatic enzyme products (PEPs), which are similar to human pancreatic enzymes, to supplement normal pancreatic function. The enzymes lipase, amylase, and protease (important pancreatic enzymes) are contained in the PEP mixture and aid in digesting fats, carbohydrates and proteins.
People with pancreatic insufficiency may also be given vitamin supplements, especially the fat-soluble vitamins A, D, E, and K, since absorption of fats (and therefore absorption of the aforementioned vitamins) is frequently impaired. They may be put on a diet low in fat and high in protein and calories to help gain and maintain weight. Limiting of alcohol intake may also be required because alcohol can cause further pancreatic damage.
In Shwachman-Diamond Syndrome (SDS), unlike in cystic fibrosis, secretion of pancreatic lipase (an enzyme that digests fats) often increases with age. The reasons for this are not yet known, but about 50% of children with SDS will experience improvements in pancreatic function and fat absorption as they get older and will no longer require enzyme replacement therapy.
For more information on other, less common conditions involving the pancreas, see Pancreas.org: Rare Syndromes.