Pancreatic Enzyme Eeplacement Therapy in paediatric care:Global insights and gaps in Bangladesh

Abstract

Pancreatic Enzyme Replacement Therapy (PERT) remains the cornerstone of managing exocrine pancreatic insufficiency (EPI), especially in children with Cystic Fibrosis (CF). Globally, Pancrelipase a high-potency, enteric-coated pancreatic enzyme is widely recommended for effective symptom control and nutritional requirements. However, in Bangladesh, a critical gap exists in both the availability of Pancrelipase and awareness regarding its appropriate use. Clinicians often rely on low-potency, non-enteric-coated enzyme preparations, leading to suboptimal outcomes. This review summarizes current international recommendations on PERT and highlights the local challenges, including limited access to standard therapy and lack of clinical guidelines tailored for Bangladeshi children. Addressing these gaps is essential to improve nutritional status, reduce morbidity, and enhance the quality of life in children with pancreatic insufficiency. The article advocates for urgent policy-level interventions and increased clinician awareness to ensure equitable access to effective enzyme therapy.

DS (Child) H J 2024; 40(2): 39-42