Fat malabsorption and enteral feeding Skip to content

Fat malabsorption and enteral feeding

See how Trenton manages pancreatic insufficiency living with cystic fibrosis

See how Trenton manages pancreatic insufficiency living with cystic fibrosis

The importance of fats in proper nutrition and health

While fats are sometimes thought of as “bad,” they actually play an important role in proper nutrition and health. A balanced ratio of omega-6 to omega-3 fatty acids has been shown to reduce the risk of many chronic diseases and is beneficial in maintaining normal development and overall health.1 The inability to breakdown and digest fats is known as malabsorption.

Fat malabsorption can result in:2,3

  • Not getting enough calories
  • An inability to gain or maintain weight
  • Weight loss
  • Lower levels of some vitamins

Fat malabsorption can look or feel like:2,3

  • Stomach pain
  • Gas
  • Oily or foul-smelling stools
  • An unusually full feeling in your stomach
  • Feeling like you may throw up

Exocrine Pancreatic Insufficiency (EPI)

Fat malabsorption is associated with a health condition called exocrine pancreatic insufficiency (EPI), where the body does not produce enough digestive enzymes or produces digestive enzymes that do not work properly. Children are most vulnerable to the consequences of untreated EPI and a delayed diagnosis often results in growth and developmental issues in addition to poor quality of life.4

Types of digestive enzymes

There are three different digestive enzymes that break down foods into nutrients for your body to use—protease breaks down proteins, amylase breaks down carbohydrates, and lipase breaks down fats. A deficiency in lipase can lead to fat malabsorption and your body may need to get lipase from another source.


pronounced “pro-tee-ace”
breaks down proteins


pronounced “am-a-lace”
breaks down carbohydrates


pronounced “lie-pace”
breaks down fats

Conditions commonly associated with fat malabsorption and EPI:3,5

  • Cystic fibrosis
  • Acute/chronic pancreatitis
  • Pancreatic cancer
  • Crohn’s disease
  • Celiac disease
  • Other inflammatory bowel diseases
  • Short bowel syndrome
  • Other cancers
  • Abdominal surgery
  • Trauma/critical care

RELiZORB is formulated for enteral nutrition

Enteral formulas contain a type of fat called triglycerides. Triglycerides are more stable and do not spoil as quickly as other types of fats, but some triglycerides are not absorbed by the body without first being broken down, resulting in fat malabsorption.

Pancreatic enzyme replacement therapy, or PERTs, are capsules containing the digestive enzymes your body would normally produce, but PERTs are designed to be taken orally and are not intended to be crushed or added to enteral formula.

RELiZORB connects directly to your feeding tube and is the only enzyme product designed to break down fats in enteral formula. The iLipase in RELiZORB is able to break down the triglycerides into absorbable forms (fatty acids and monoglycerides) during enteral tube feeding, before entering the body.

feeding tube

RELiZORB vs. oral PERT for continuous overnight enteral feeding

RELiZORB is intended to provide continuous fat hydrolysis during overnight enteral feeding*
Oral PERT is active in the GI tract for about 45-60 minutes after administration[CFF]

*Timing is based on volume and flow rate. A single RELiZORB cartridge can be used for up to 500mL of formula at a rate of 10-120 mL/hr. A tandem RELiZORB cartridge configuration can be used for over 500mL and up to 1000mL of formula at a rate of 24-120 mL/hour. Please see additional details in the Instructions for Use.

  1. Simopoulos AP. The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomed Pharmacother. 2002 Oct;56(8):365-79.
  2. Blaauw R. Malabsorption: causes, consequences, diagnosis and treatment. S Afr J Clin Nutr. 2011;24(3):125-127.
  3. MedLinePlus Website. https://medlineplus.gov/ency/article/000299.htm. Accessed October 7, 2021.
  4. Sankararaman S, Schindler T, and Sferra TJ. Management of Exocrine Pancreatic Insufficiency in Children. Nutrition in Clinical Practice. 2019;34(1):S27-S42.
  5. 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.
  6. Cystic Fibrosis Foundation. https://www.cff.org/Life-With-CF/Daily-Life/Fitness-and-Nutrition/Nutrition/Taking-Care-of-Your-Digestive-System/Enzymes/. Accessed April 19, 2018.