New research project: what is pancreatic exocrine insufficiency and how can we diagnose it more quickly?

What is pancreatic exocrine insufficiency?

Pancreatic exocrine insufficiency (PEI) occurs when the pancreas becomes unable to produce enough enzymes to break down food, and effectively causes the body to starve. The condition affects 60-90% of people with pancreatic cancer. 

How can PEI be treated?

PEI can be treated with simple tablets called Pancreatic Enzyme Replacement Therapy (PERT), which replace those enzymes so that food can be digested again. Shockingly, however, just half of people with pancreatic cancer are prescribed the medicine in the UK, despite it being readily available. This is due in part to the fact that GPs don’t have the right tools to diagnose PEI quickly or accurately enough. 

Finding new ways to diagnose PEI quickly and accurately 

We’re delighted to announce that one of our latest projects, led by Professor Keith Roberts at the University of Birmingham, is working towards the creation of a simple, same day test for PEI. 

We caught up with Sarah, who is working on the project, about how the study will help GPs provide more people with the vital PERT medication they need to live better and longer lives. 

The need for a new test for PEI

The current method of testing for PEI is incredibly unpleasant for patients, as it requires faecal testing over five days. The process is slow, inaccurate, and cannot be used to measure how well the enzymes are working or guide the treated needed by each individual. As a result, patients often receive the incorrect dosage of PERT, meaning they struggle to eat, stay healthy enough to tolerate treatment or manage debilitating symptoms from the cancer, including abdominal pains, diarrhoea, weight loss, bloating, increased fractures, heart trouble, muscle wasting and ultimately, shorter survival rates. 

People with pancreatic cancer desperately need a new diagnostic test to make it quick, easy and more pleasant to diagnose enzyme insufficiency so that they can get the treatment they need. 

By measuring the products of digestion from blood samples of people with normal enzyme function and those with exocrine insufficiency, Sarah and the team at University of Birmingham aim to do just that.

How will the study work? 

They will compare the number of metabolites in the blood of 30 people with PEI and 20 healthy volunteers, each of whom will eat a high-fat content breakfast. Their blood will be taken at different times throughout the day. 

It is hoped that the difference in metabolites present in the blood between the two sets of people will be significant enough to form the basis of a medical test that will enable health professionals to provide personalised doses of PERT for the first time. 

Next steps

If successful, the study will hopefully result in a simple, fingerprint blood test to be rolled out within the NHS, that GPs, or even people in their own homes, can use not only to diagnose PEI but guide how much PERT medication is needed to bring enzyme function back to normal and allow people with pancreatic cancer to live better and longer lives.  

We hope this research leads to an easy, same-day test rolled out across the UK in the future. Being able to test for PEI in the comfort of your own home would be a huge step forward for pancreatic cancer patients.

Dr Sarah Powell-Brett

A test for PEI could mean that thousands of people receive the proven, inexpensive medication which is already available to stop anyone having to watch a loved one waste away from this devastating disease. That’s what makes this innovative project so exciting – and why I’m so proud we’re funding it.

Dr Chris Macdonald, Head of Research at Pancreatic Cancer UK