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See RELiZORB real-world results #

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Upcoming Educational Programs
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RELiZORB (iMMOBILIZED LIPASE) CARTRIDGE

Recognize, Confirm, & Address Fat Malabsorption

Symptoms of fat malabsorption require urgent action and nutritional support to help avoid complications or developmental delays1-3

RECOGNIZE fat malabsorption

Don’t overlook the burdens and consequences of fat malabsorption4

Fats are essential nutrients with unique roles in maintaining health. When pancreatic function or gastrointestinal (GI) absorptive area are compromised, fat digestion and absorption suffer—even if protein and carbohydrate digestion remain intact.1,4-6

Survey results on fat malabsorption symptoms in people who tube feed7

Alcresta Therapeutics, Inc. partnered with the Oley Foundation to conduct an online survey to better understand the knowledge of patients who tube feed and potential nutritional challenges, including fat malabsorption and/or tube-feeding intolerance.

A total of 201 individuals participated, including tube-fed patients and caregivers of tube-fed patients. Survey participants were compensated.

Fats play a vital role, starting at the cellular level5,6

Only lipase can hydrolyze fats into fatty acids and accounts for a majority of fatty acid digestion.8

  • Fatty acids come from medium- and long-chain triglycerides (MCTs and LCTs)6,9
  • Hydrolyzed LCTs produce omega-3 fatty acids (DHA and EPA), which support health6
    • LCTs are the only source of omega-3s
  • DHA and EPA may provide clinically relevant anti-inflammatory effects in conditions linked to fat malabsorption10,11

Omega-3 fatty acids support the development and function of multiple bodily systems6:

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Central nervous
system10,12
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Cardiovascular
system5
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Immune
system6,12
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Metabolism5,6
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Lipid
homeostasis6,12
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Fats play a key role in growth and development during adolescence and provide a higher concentration of calories than proteins and carbohydrates (9 cal/g vs 4 cal/g, respectively).12-14

Recognize at-risk patients

Fat malabsorption may limit the benefit of enteral nutrition14,15

Tube feeding is often used for nutritional support in conditions associated with fat malabsorption like short bowel syndrome (SBS) and exocrine pancreatic insufficiency (EPI). Unmanaged fat malabsorption can put these patients at risk of burdensome symptoms and long-term complications.

Watch the videos below to gain a deeper understanding of the role these conditions play in fat digestion.

Explore fat malabsorption in SBS

See the impact limited absorptive area has on fat digestion and how it can affect someone living with SBS.

Review fat malabsorption in EPI

Watch to learn about the effects of limited enzyme secretion on fat digestion and how it impacts those living with EPI.

Fat malabsorption and EPI are associated with other conditions and clinical situations, such as4,11,16-18:

  • Cystic fibrosis
  • Acute/chronic pancreatitis
  • Trauma/critical care
  • Pancreatic and other GI cancers
  • GI surgery
  • Inflammatory bowel disease
Portrait of Dr. Hillary Bashaw, MD

Hear from your peer, Hillary Bashaw, MD, as she discusses how she used RELiZORB to manage fat malabsorption in a 10-year-old with SBS.

Watch the video

Confirm with signs and symptoms

Fat malabsorption can cause debilitating and long-lasting consequences1-3

Diagnosing fat malabsorption early is critical. Symptoms of tube-feeding intolerance due to fat malabsorption should not be overlooked as they add excess burden and discomfort to patients who are already vulnerable.

If a patient who tube feeds has any of these symptoms, it may be fat malabsorption1:

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Weight loss
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Fatigue
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Diarrhea
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Bloating and gas
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Abdominal pain
and discomfort
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Steatorrhea

Left unmanaged, fat malabsorption can lead to devastating long-term outcomes such as2,18,19:

  • Malnutrition
  • Vitamin deficiency
  • Chronic infection
  • Inability to gain weight
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Long-term impacts like malnutrition and vitamin deficiency can result in developmental delays in pediatric patients.14,20

Confirm management method

Managing fat malabsorption may take more than traditional methods14,21-26

Common methods of managing fat malabsorption in patients who tube feed—such as formula changes or additives, feeding rate adjustments, and pancreatic enzyme replacement therapy (PERT)—can be limited or even contribute to worsening symptoms.

Many formulas contain prehydrolyzed proteins and carbohydrates but cannot contain prehydrolyzed fats, as they are unstable and spoil quickly.21,27

Consider a different approach to address the consequences of fat malabsorption in your patients with SBS, EPI, and other GI conditions.

Address questions with
the Spotlight Series

RELiZORB Spotlight Series: Get an expert’s perspective on fat malabsorption from Candi Jump, DO, MSED, CNSC

Hear from an expert on the impact, signs, diagnosis, and management of fat malabsorption in different care settings.

General malabsorption vs fat malabsorption

Uncover the vital role of proper fat absorption, and learn about the signs and symptoms that can lead to a fat malabsorption diagnosis.

Fat malabsorption in SBS

Delve into the physiology of fat malabsorption and management strategies that optimize nutrition, reduce symptoms, and enhance tube feeding.

Importance of enteral autonomy when managing SBS

Discover strategies that enhance enteral nutrition tolerance, with a focus on improving fat absorption in patients with SBS.

Image of the cover and inside spread of the downloadable RELiZORB Fat Malabsorption Guide PDF

Fat Malabsorption Guide

Fat malabsorption can be challenging to identify and manage. Download the Fat Malabsorption Guide for more details.1,4

Download guide #

Address by prehydrolyzing
fats with RELiZORB

Hydrolyze fats in enteral nutrition prior to ingestion28

RELiZORB is a digestive enzyme that mimics the function of lipase to break down fats, like MCTs and LCTs, in enteral nutrition into an absorbable form.

The RELiZORB cartridge connected to feeding tubing to hydrolyze fats in enteral formula
Caleb, who uses RELiZORB, riding his bike with help from his father Jimmy

Caleb, a child who tube feeds with RELiZORB, and his father, Jimmy

RELiZORB has more to offer your patients who tube feed

Learn about RELiZORB

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DHA=docosahexaenoic acid; EPA=eicosapentaenoic acid.

* Among people who reported symptoms of fat malabsorption.7

References: 1. Alkaade S, Vareedayah AA. A primer on exocrine pancreatic insufficiency, fat malabsorption, and fatty acid abnormalities. Am J Manag Care. 2017;23(suppl 12):S203-S209. 2. Blaauw R. Malabsorption: causes, consequences, diagnosis and treatment. S Afr J Clin Nutr. 2011;24(3):125-127. 3. Domínguez-Muñoz JE. Pancreatic exocrine insufficiency: diagnosis and treatment. J Gastroenterol Hepatol. 2011;26(suppl 2):12-16. doi:10.1111/j.1440-1746.2010.06600.x 4. Singh VK, Haupt ME, Geller DE, Hall JA, Quintana Diez PM. Less common etiologies of exocrine pancreatic insufficiency. World J Gastroenterol. 2017;23(39):7059-7076. doi:10.3748/wjg.v23.i39.7059 5. Omega-3 fatty acids: an essential contribution. Harvard T.H. Chan School of Public Health. Accessed November 28, 2023. https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-and-cholesterol/types-of-fat/omega-3-fats/ 6. Omega-3 fatty acids: fact sheet for health professionals. National Institutes of Health: Office of Dietary Supplements. Updated July 18, 2022. Accessed November 28, 2023. https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/ 7. Data on file, Alcresta Therapeutics, Inc. 8. Whitcomb DC, Lowe ME. Human pancreatic digestive enzymes. Dig Dis Sci. 2007;52(1):1-17. doi:10.1007/s10620-006-9589-z 9. Shah ND, Limketkai BN. The use of medium-chain triglycerides in gastrointestinal disorders. Practical Gastroenterol. 2017;41(2):20-28. 10. Calder PC. Omega-3 fatty acids and inflammatory processes. Nutrients. 2010;2(3):355-374. doi:10.3390/nu2030355 11. National Institutes of Health. Malabsorption. Medline Plus. Updated May 6, 2022. Accessed November 28, 2023. https://medlineplus.gov/ency/article/000299.htm 12. Abedi E, Sahari MA. Long-chain polyunsaturated fatty acid sources and evaluation of their nutritional and functional properties. Food Sci Nutr. 2014;2(5):443-463. doi:10.1002/fsn3.121 13. Fat and calories. Cleveland Clinic. April 25, 2019. Accessed November 28, 2023. https://my.clevelandclinic.org/health/articles/4182-fat-and-calories 14. Freedman S, Orenstein D, Black P, et al. Increased fat absorption from enteral formula through an in-line digestive cartridge in patients with cystic fibrosis. J Pediatr Gastroenterol Nutr. 2017;65(1):97-101. doi:10.1097/MPG.0000000000001617 15. Short bowel syndrome. National Institute of Diabetes and Digestive and Kidney Diseases. Updated April 2023. Accessed November 29, 2023. https://www.niddk.nih.gov/health-information/digestive-diseases/short-bowel-syndrome/all-content 16. Capurso G, Traini M, Piciucchi M, Signoretti M, Arcidiacono PG. Exocrine pancreatic insufficiency: prevalence, diagnosis, and management. Clin Exp Gastroenterol. 2019;12:129-139. doi:10.2147/CEG.S168266 17. Surmelioglu A, Ozkardesler E, Tilki M, Yekrek M. Exocrine pancreatic insufficiency in long-term follow-up after curative gastric resection with D2 lymphadenectomy: a cross-sectional study. Pancreatology. 2021;21(5):975-982. doi:10.1016/j.pan.2021.03.019 18. Blonk L, Wierdsma NJ, Jansma EP, Kazemier G, van der Peet DL, Straatman J. Exocrine pancreatic insufficiency after esophagectomy: a systematic review of literature. Dis Esophagus. 2021;34(12):1-6. doi:10.1093/dote/doab003 19. Malik Z. Overview of Malabsorption. In: Merck Manual Professional Version. Merck & Co., Inc.; 2023. 20. Turck D, Braegger CP, Colombo C, et al. ESPEN-ESPGHAN-ECFS guidelines on nutrition care for infants, children, and adults with cystic fibrosis. Clin Nutr. 2016;35(3):557-577. doi:10.1016/j.clnu.2016.03.004 21. Limketkai BN, Shah ND, Sheikh GN, Allen K. Classifying enteral nutrition: tailored for clinical practice. Curr Gastroenterol Rep. 2019;21(9):47. doi:10.1007/s11894-019-0708-3 22. Parrish CR, Copland AP. Enteral nutrition in the adult short bowel patient: a potential path to central line freedom. Practical Gastroenterol. 2021;45(4):36-51. 23. Parrish CR, DiBaise JK. Managing the adult patient with short bowel syndrome. Gastroenterol Hepatol (NY). 2017;13(10):600-608. 24. Nguyen DL. Guidance for supplemental enteral nutrition across patient populations. Am J Manag Care. 2017;23(12):S210-S219. 25. Schwarzenberg SJ, Hempstead SE, McDonald CM, et al. Enteral tube feeding for individuals with cystic fibrosis: Cystic Fibrosis Foundation evidence-informed guidelines. J Cyst Fibros. 2016;15(6):724-735. doi:10.1016/j.jcf.2016.08.004 26. Berry AJ. Pancreatic enzyme replacement therapy during pancreatic insufficiency. Nutr Clin Pract. 2014;29(3):312-321. doi:10.1177/0884533614527773 27. Mahesar SA, Sherazi STH, Khaskheli AR, Kandhro AA, Uddin S. Analytical approaches for free fatty acids assessment in oils and fats. Anal Methods. 2014;14(6):4956-4963. doi:10.1039/C4AY00344F 28. RELiZORB. Instructions for use. Alcresta Therapeutics, Inc; 2025.

RELiZORB is indicated for use in pediatric (including neonates and infants) and adult patients to hydrolyze fats during enteral feeding.

Warnings
  • RELiZORB is for use with enteral tube feeding only.
See more
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RELiZORB is indicated for use in pediatric (including neonates and infants) and adult patients to hydrolyze fats during enteral feeding.

Warnings
  • RELiZORB is for use with enteral tube feeding only.
  • RELiZORB should not be connected to any intravenous (IV) line, setup, or system.
  • Medications should not be administered through the RELiZORB cartridge. Do not add medications to the enteral nutrition or tubing before RELiZORB. The passage of medications through RELiZORB may adversely affect the medications or the ability of RELiZORB to hydrolyze fats.
  • Fibrosing Colonopathy - Fibrosing colonopathy is a rare, serious adverse reaction associated with high-dose use of pancreatic enzyme replacement therapy in the treatment of patients with cystic fibrosis. The underlying mechanism of fibrosing colonopathy remains unknown. Patients with fibrosing colonopathy should be closely monitored because some patients may be at risk of progressing to stricture formation. RELiZORB contains lipase enzyme that is not from a porcine source. The lipase is bound to the beads, and this lipase-bead complex (iLipase) is retained within the RELiZORB cartridge. Continue to follow your physician’s guidance and porcine pancreatic enzyme labeling regarding porcine pancreatic enzyme use when used in conjunction with RELiZORB.
Cautions and Precautions
  • Do not re-use RELiZORB. RELiZORB is a single-use product. Re-use may result in contamination of the product. If re-used, RELiZORB may not effectively hydrolyze fats.
  • Do not break, alter, or place excess pressure on any part of RELiZORB. Any compromise of the structural integrity of RELiZORB may lead to improper connection to enteral feeding supplies, leakage or risk of contamination.
  • Do not use RELiZORB after the date marked on the pouch.
  • Enteral nutrition administered through RELiZORB is for immediate consumption through an enteral feeding tube. RELiZORB should not be used to process enteral nutrition for later use. This has not been tested and may result in safety issues.
  • RELiZORB is designed for use with enteral feeding pump systems with low flow/no flow alarms and enteral syringes for manual bolus by syringe (push or gravity). A detailed listing of enteral nutrition, pumps, and enteral feeding supplies compatible with RELiZORB can be found at www.relizorbhcp.com/compatibility.
  • Patients less than 1 year old may be particularly vulnerable to unplanned interruptions of feeding.
  • Do not use blenderized formulas with RELiZORB. A detailed listing of enteral nutrition compatible with RELiZORB can be found at www.relizorbhcp.com/compatibility.
  • Powdered formulas should be mixed periodically during feedings.
  • Do not use excessive force on the plunger when using RELiZORB with bolus syringe feeding method.
  • Do not rush bolus feeds. Follow guidance from your healthcare professional on how long it should take you to complete your tube feeding. Ensure all inlet and outlet connectors on RELiZORB and enteral feeding supplies are clean and dry prior to making connections.
  • In order to ensure product performance, store RELiZORB in its pouch either refrigerated or at room temperature (2°C to 27°C; 36°F to 80°F).
  • RELiZORB is indicated for use with enteral feeding only; patients should follow physician’s guidance for pancreatic enzyme replacement therapy (PERT) use for meals and snacks. Patients and patient caregivers should follow physician’s guidance regarding the need for pancreatic enzyme replacement therapy (PERT) during enteral feeding.

Review full product information for RELiZORB in the Instructions for Use.