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Crohn's disease is a painful inflammatory disorder of the ileum, a segment of the intestine. It can lead to malabsorption of nutrients, and if the ileum perforates, the condition can be fatal. It has been reported that patients with Crohn's disease also suffer from exocrine pancreatic insufficiency (failure to produce sufficient digestive enzymes). However, it is not known whether this is a primary effect, or simply a result of protein deficiency secondary to the malabsorption. To investigate pancreatic function in individuals with Crohn's disease, a study was done with 143 patients with this condition, and with 115 normal control subjects. After an overnight fast, a standardized test meal was given, and the contents of the duodenum (the upper part of the intestine, into which pancreatic enzymes are secreted) were aspirated and levels of amylase (a starch-digesting enzyme) and lipase (a fat-digesting enzyme) were measured. Crohn's disease patients had significantly lowered levels of both these enzymes. The magnitude of the lowering was not related to the duration of the disease, but it was related to the area of the intestine affected. Patients with inflammation of the terminal, or most distant, portion of the ileum had the lowest enzyme levels. In the overall population, there was no correlation between severity of the disease and enzyme levels, but in the group with terminal ileus inflammation, these two variables were correlated. (Consumer Summary produced by Reliance Medical Information, Inc.)