Rational Use of Pancreatic Enzymes for Pancreatic Insufficiency and Pancreatic Pain.

ABSTRACT: We describe the rational use of enteric coated and unprotected replacement pancreatic enzymes for treatment of malabsorption due to pancreatic insufficiency and for pancreatic pain. Enteric coated formulations mix poorly with food allowing separation of enzymes and nutrients when emptying from the stomach. The site of dissolution of the enteric coating in the intestine is also unpredictable and enzymes may not be released until the distal intestine. Together, these barriers result in the lack of dose-response such that the strategy of increasing the dosage following a suboptimal effect is often ineffective. The ability to maintain the intragastric pH ≥4 with the combination of proton pump inhibitors and antacids suggests that it should be possible to reliably obtain a good response with un

SUBMITTER: Ketwaroo GA 

PROVIDER: S-EPMC6913179 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature