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Practical Approaches Along the Pathway of Pancreatic Exocrine Insufficiency

  • Authors: Matthias Löhr, MD, PhD
  • CME Released: 3/22/2023
  • Valid for credit through: 3/22/2024, 11:59 PM EST
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  • Credits Available

    Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)™

    You Are Eligible For

    • Letter of Completion

Target Audience and Goal Statement

This educational activity is intended for an international audience of non-US gastroenterologists/hepatologists and surgeons who manage pancreatic exocrine insufficiency.

The goal of this activity is for learners to be better able to diagnose and manage PEI in their patients with chronic pancreatitis.

Upon completion of this activity, participants will:

  • Have greater knowledge regarding the
    • Recommended optimal dosing of pancreatic enzymes for PEI
  • Have greater competence related to
    • Selecting appropriate tests for patients at risk of PEI based on symptoms and medical history
    • Optimizing pancreatic enzyme replacement therapy (PERT) in patients with a suboptimal response


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All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships.


  • Matthias Löhr, MD, PhD

    Professor of Gastroenterology
    Karolinska Institutet
    Stockholm, Sweden


    Matthias Löhr, MD, PhD, has the following relevant financial relationships:
    Consultant or advisor for: iCellate AB; PharmaCyte Biotech, Inc.; Zedira GmbH
    Speaker or member of speakers bureau for: Abbott Laboratories; Viatris
    Owns stock (publicly traded) in: Centogene AG; PharmaCyte Biotech, Inc.


  • Roderick Smith, MS

    Senior Medical Education Director, Medscape, LLC


    Roderick Smith, MS, has no relevant financial relationships.

  • Gina Montanero, Pharm D

    CME Writer, Medscape, LLC


    Gina Montanero, Pharm D, has no relevant financial relationships.

Compliance Reviewer

  • Yaisanet Oyola, MD

    Associate Director, Accreditation and Compliance, Medscape, LLC


    Yaisanet Oyola, MD, has no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has no relevant financial relationships.

Accreditation Statements


Interprofessional Continuing Education

In support of improving patient care, Medscape, LLC is jointly accredited with commendation by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

    For Physicians

  • Medscape, LLC designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    EACCME Reciprocity:

    The European Union of Medical Specialists (UEMS)-European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 credit™ into European CME credit (ECMEC) should contact the UEMS (

    College of Family Physicians of Canada Reciprocity:

    College of Family Physicians of Canada Mainpro+® participants may claim certified credits for any AMA PRA Category 1 credit(s)™, up to a maximum of 50 credits per five-year cycle. Any additional credits are eligible as non-certified credits. College of Family Physicians of Canada (CFPC) members must log into Mainpro+® to claim this activity.

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Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

  1. Read about the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or print it out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate, but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period, you can print out the tally as well as the certificates from the CME/CE Tracker.

*The credit that you receive is based on your user profile.


Practical Approaches Along the Pathway of Pancreatic Exocrine Insufficiency

Authors: Matthias Löhr, MD, PhDFaculty and Disclosures

CME Released: 3/22/2023

Valid for credit through: 3/22/2024, 11:59 PM EST


Maria is a 46-year-old woman who was referred from her primary care physician for persistent abdominal pain, diarrhea, flatulence, and weight loss. An endoscopy showed mild gastritis but was otherwise normal. Tests for C. difficile and H. pylori were negative. An abdominal ultrasound was normal; there were no gallstones, and the pancreas could not be seen. Maria has no prior history of celiac disease and no family history of cancer or pancreatitis, colorectal cancer, or inflammatory bowel disease. Her original weight was 70 kg; she is now 64 kg, height 165 cm, and BMI is 24 kg/m2. Maria has a history of heavy drinking and 20-year history of 1 pack per day cigarette smoking.

Current medications: Esomeprazole 40 mg daily as needed; loperamide 4 mg as needed for diarrhea.

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