From the Guidelines
Long-term use of prednisone does not directly cause pancreatic insufficiency, but it can increase the risk of developing diabetes, which may indirectly affect pancreatic function. Pancreatic insufficiency occurs when the pancreas doesn't produce enough digestive enzymes, leading to malabsorption and digestive symptoms. According to the 2020 guidelines from the American Association for the Study of Liver Diseases 1, the side effects of prolonged prednisone use include glucose intolerance/diabetes, but there is no mention of pancreatic insufficiency as a direct side effect.
While prednisone has many potential side effects, including diabetes, osteoporosis, muscle weakness, and increased infection risk, it doesn't directly damage pancreatic exocrine function. However, prednisone can cause or worsen diabetes by increasing insulin resistance and reducing insulin production, affecting the pancreas's endocrine function. If you're experiencing symptoms like fatty stools, weight loss, abdominal pain, or bloating while on long-term prednisone, these are more likely due to other causes such as chronic pancreatitis, cystic fibrosis, pancreatic cancer, or surgical removal of the pancreas.
Key points to consider:
- Prednisone can increase the risk of developing diabetes, which may indirectly affect pancreatic function
- Pancreatic insufficiency is not a direct side effect of prednisone use, according to the 2020 guidelines from the American Association for the Study of Liver Diseases 1
- Symptoms like fatty stools, weight loss, abdominal pain, or bloating may be due to other causes, and proper evaluation by a healthcare provider is necessary
- Treatment for pancreatic insufficiency typically involves pancreatic enzyme replacement therapy, not discontinuation of prednisone.
From the Research
Long-term Use of Prednisone and Pancreatic Insufficiency
- There is no direct evidence in the provided studies that long-term use of prednisone (corticosteroid) causes pancreatic insufficiency 2, 3, 4, 5, 6.
- A study on autoimmune pancreatitis after oral prednisolone therapy found no deterioration of pancreatic exocrine function in any of the patients 2.
- Other studies focused on pancreatic exocrine insufficiency (PEI) and its treatment with pancreatic enzyme replacement therapy (PERT), but did not investigate the effect of prednisone on pancreatic function 3, 4, 6.
- A study on corticosteroid-induced clinical adverse events found that lipodystrophy, neuropsychiatric disorders, and skin disorders were common adverse events of long-term prednisone therapy, but did not mention pancreatic insufficiency 5.