Patients undergoing EGD with ePFT for symptoms of suspected or known pancreatic insufficiency.

Patients undergoing diagnostic EGD that consent to undergo ePFT.

Abdominal Pain

Irritable Bowel Syndrome

Secretin is a gastrointestinal peptide hormone, indicated for the stimulation of: pancreatic secretions, including bicarbonate, to aid in the diagnosis of pancreatic exocrine dysfunction.

synthetic human secretin

Recurrent Abdominal Pain and Exocrine Pancreatic Insufficiency

Secretin stimulated exocrine pancreatic enzyme activity will be measured in patients with abdominal pain who are undergoing upper endoscopy to identify those with insufficiency (EPI).

This includes immunological and genetic markers.

Devendra Mehta

Director, Pediatric Gastroenterology Laboratory, Arnold Palmer Hospital for Children

Orlando Health, Inc.

ChiRhoClin, Inc.

Cream of chicken soup (400g) (or mushroom for vegetarians) (Heinz, Wigan, UK) used as a test meal intervention. The nutrient content /100g is: energy (kcal) 51, protein (g) 1.5, carbohydrate (g) 4.7, fat (g) 2.93

Healthy

Soup meal

Nottingham Digestive Diseases Centre, QMC Campus, Nottingham University Hospitals

Magnetic Resonance Imaging of Motility in Crohn's 1

Reduced Intestinal Motility in Inflammatory Crohn's Disease - Optimisation Studies in Healthy Volunteers

MRI small bowel motility index (arbitrary units)

Gastric emptying from gastric volumes time courses

Small bowel water content from MRI images

Whole gut transit weighted average position scores

University of Nottingham

The study will be limited to NHS patients to reduce complications associated with the need for additional funding authorisations from private health care providers for algorithm-instigated investigations. It is not envisaged that participation in other studies running within the GI unit at The Royal Marsden Hospital will preclude entry into this study except in the event of those rare studies where the study is specifically measuring toxicity of treatment as the primary end point.

Blood and Stool Samples will be collected for translational analysis.

Cancer

The Royal Marsden NHS Foundation Trust

The FOCCUS Study: "Focusing on Cancers Chemotherapys' Untreated Symptoms"

The FOCCUS Study: "Focusing on Cancer Chemotherapys' Untreated Symptoms"

Royal Marsden NHS Foundation Trust

Pancrease MT 10.5 or MT 21 Pancrease MT capsules for maximum dose of 10 000 lipase units / Kg / day

Placebo for Pancrease MT 10.5 or MT 21 Capsules with Pancrease MT excipients without the active enzymes

Matching placebo capsules taken by mouth per meal or snack

Placebo

Pancrease MT 10.5 or MT 21 capsules taken by mouth per meal or snack

PANCREASE MT

Total

Sex: Female, Male

Race (NIH/OMB)

Change in the coefficient of fat absorption (percent COA-fat) from the 72-hour inpatient period in the open-label phase to the 72-hour period inpatient period in the double-blind (withdrawal) phase.

Change in the Coefficient of Fat Absorption (COA-fat Percent)

The change in percent COA-protein from the stool collection period in double-blind phase to open-label phase

Change in Percent COA-Protein (Nitrogen)

Percent of patients reporting nausea, vomiting, bloating, diarrhea, oily/greasy stools, and abdominal pain signs and symptoms reported as Adverse events during the double-blind phase.

Percent of Patients Reporting Clinical Signs and Symptoms of Exocrine Pancreatic Insufficiency (EPI) During the Double-Blind Phase

Overall Study

Director, Clinical Team Leader