Pancreatic Insufficiency

Pancreatic enzyme insufficiency is consistent with Klebsiella overgrowth because Klebsiella is an aggressive protein scavenger that feeds on undigested protein. The pancreas has both an endocrine function (insulin and glucagon) and an exocrine function (secreting digestive enzymes into the small intestine). Lipase is the critical pancreatic enzyme for fat absorption, cleaving triglycerides into absorbable free fatty acids and monoglycerides. Elastase-1 below 500 µg/g indicates severely reduced pancreatic enzyme secretion, leaving undigested macronutrients as substrate that feeds existing dysbiosis. Pancreatitis is most commonly caused by gallstones or gallbladder sludge blocking the bile ducts. Fat-soluble vitamins A, D, E, and K cannot be absorbed when fat digestion is impaired by pancreatic enzyme insufficiency. Diabetes is associated with reduced pancreatic enzyme output, meaning the same gland that fails to regulate blood sugar also fails to produce adequate digestive enzymes. Steatorrhea — large-volume, foul-smelling, pale or floating stools — is a hallmark symptom of pancreatic enzyme insufficiency. Chronic diabetes strains the enzyme-producing portion of the pancreas, leadi…