Useful Information On Pancreatin
The pancreas is a large gland that lies in the upper abdomen, behind the lower part of
the stomach. It serves two major functions. One is to produce the hormones insulin and
glucagon, which help regulate metabolism. The other is to produce pancreatic juice, a
secretion delivered into the upper part of the small intestine (duodenum), where it aids
digestion.
Pancreatin is a mixture of the fat dissolving enzyme, lipase, the protein enzymes such
as protease, and those that break down carbohydrates like amylase. The enzymes in
pancreatin may come from pork or beef. If you are vegetarian or have allergies or
religious restrictions to any of these items, you should know this. Pancreatic enzymes are
not standardized, and contain a variety of enzymes, including trypsin, chymotrypsin,
lipase, amylase, colipase, and ribonuclease.
These enzymes catalyze the hydrolysis of fats into glycerol and fatty acids, protein
into proteoses and derived substances, and starch into dextrins and sugars.
Pancreatin tablets are prescribed for patients who are unable to digest food properly
because of an insufficient amount of natural pancreatic secretions. This deficit may be
caused by disorders of the pancreas, for example, cystic fibrosis or pancreatitis.
When malabsorption is due to reduced exocrine pancreatic function, improved digestion
of food can lead to enhanced nutrient absorption, prevention of weight loss and diarrhea,
reduction of steatorrhea, and promotion of weight gain.
Enzymes work best when taken just before, during and immediately after a meal. When
possible, swallow the pills whole. Do not chew.
It is chiefly in the management of pancreatic exocrine insufficiency that
supplementation with digestive enzymes is beneficial to the nutritional status and
gastrointestinal functioning of selected patients. Anecdotal reports suggest that some
dyspeptic and functional gastrointestinal conditions may sometimes benefit from a trial of
such therapy.
Exocrine pancreatic insufficiency combined with pancreatic pain and endocrine
pancreatic insufficiency are the leading symptoms of chronic pancreatitis. Due to the
large functional reserve capacity of the gland, decompensation, i.e. steatorrhea, does not
occur before lipase excretion is reduced to < or = 10% of normal. Pancreatic enzyme
substitution is indicated when fecal fat excretion exceeds a critical value (normally >
15 g/day) and/or when weight loss is present. A number of studies have dealt with the
problems of gastric acid inactivation of pancreatic enzyme preparations as well as their
gastric emptying nonsimultaneously with the food. For the present, it is recommended that
pancreatic enzyme substitution in patients with proven exocrine pancreatic insufficiency
and normal gastric acid secretion be given in multiunit, acid-protected dosages. In
patients with gastric hyposecretion and in those who underwent partial or total
gastrectomy, enzyme substitution should be administered as granules to enable
mixing and simultaneous transport of enzymes with the chyme. The ultimate aim of further
scientific and clinical research remains the total abolishment of pancreatic
steatorrhea.
Known Hazards: Excessive doses of pancreatic enzyme replacement may result in
gastrointestinal adverse effects, ie, nausea, vomiting, diarrhea, and abdominal
cramps/pain. Very high doses have been reported to cause hyperuricosuria and
hyperuricemia. Patients with a history of sensitivity to pork products, trypsin,
pancrelipase, or pancreatin may develop allergic reactions.
- DIGESTIVES, INCLUDING ENZYMES. Department of Pharmacology University of Cape Town
- Lankisch PG. Enzyme treatment of exocrine pancreatic insufficiency in chronic pancreatitis. Digestion 1993;54 Suppl 2:21-9
The pancreas is a large gland that lies in the upper abdomen, behind the lower part of
the stomach. It serves two major functions. One is to produce the hormones insulin and
glucagon, which help regulate metabolism. The other is to produce pancreatic juice, a
secretion delivered into the upper part of the small intestine (duodenum), where it aids
digestion.
Pancreatin is a mixture of the fat dissolving enzyme, lipase, the protein enzymes such
as protease, and those that break down carbohydrates like amylase. The enzymes in
pancreatin may come from pork or beef. If you are vegetarian or have allergies or
religious restrictions to any of these items, you should know this. Pancreatic enzymes are
not standardized, and contain a variety of enzymes, including trypsin, chymotrypsin,
lipase, amylase, colipase, and ribonuclease.
These enzymes catalyze the hydrolysis of fats into glycerol and fatty acids, protein
into proteoses and derived substances, and starch into dextrins and sugars.
Pancreatin tablets are prescribed for patients who are unable to digest food properly
because of an insufficient amount of natural pancreatic secretions. This deficit may be
caused by disorders of the pancreas, for example, cystic fibrosis or pancreatitis.
When malabsorption is due to reduced exocrine pancreatic function, improved digestion
of food can lead to enhanced nutrient absorption, prevention of weight loss and diarrhea,
reduction of steatorrhea, and promotion of weight gain.
Enzymes work best when taken just before, during and immediately after a meal. When
possible, swallow the pills whole. Do not chew.
It is chiefly in the management of pancreatic exocrine insufficiency that
supplementation with digestive enzymes is beneficial to the nutritional status and
gastrointestinal functioning of selected patients. Anecdotal reports suggest that some
dyspeptic and functional gastrointestinal conditions may sometimes benefit from a trial of
such therapy.
Exocrine pancreatic insufficiency combined with pancreatic pain and endocrine
pancreatic insufficiency are the leading symptoms of chronic pancreatitis. Due to the
large functional reserve capacity of the gland, decompensation, i.e. steatorrhea, does not
occur before lipase excretion is reduced to < or = 10% of normal. Pancreatic enzyme
substitution is indicated when fecal fat excretion exceeds a critical value (normally >
15 g/day) and/or when weight loss is present. A number of studies have dealt with the
problems of gastric acid inactivation of pancreatic enzyme preparations as well as their
gastric emptying nonsimultaneously with the food. For the present, it is recommended that
pancreatic enzyme substitution in patients with proven exocrine pancreatic insufficiency
and normal gastric acid secretion be given in multiunit, acid-protected dosages. In
patients with gastric hyposecretion and in those who underwent partial or total
gastrectomy, enzyme substitution should be administered as granules to enable
mixing and simultaneous transport of enzymes with the chyme. The ultimate aim of further
scientific and clinical research remains the total abolishment of pancreatic
steatorrhea.
Known Hazards: Excessive doses of pancreatic enzyme replacement may result in
gastrointestinal adverse effects, ie, nausea, vomiting, diarrhea, and abdominal
cramps/pain. Very high doses have been reported to cause hyperuricosuria and
hyperuricemia. Patients with a history of sensitivity to pork products, trypsin,
pancrelipase, or pancreatin may develop allergic reactions.
- DIGESTIVES, INCLUDING ENZYMES. Department of Pharmacology University of Cape Town
- Lankisch PG. Enzyme treatment of exocrine pancreatic insufficiency in chronic pancreatitis. Digestion 1993;54 Suppl 2:21-9
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