Interní Med. 2015; 17(5): 227-229

Not only diseases of the pancreas and their therapy with pancreatic enzymes

prof.MUDr.Petr Dítě, DrSc.¹, MUDr.Martina Bojková¹, Mgr.Jarmila Šímová², MUDr.Bohuslav Kianička, Ph.D.³, MUDr.Kateřina Kapounková⁴, MUDr.Vladimír Hrabovský, Ph.D.⁴

¹ Akademické centrum gastroenterologie, Interní klinika FN a LF Ostrava

² CGB Laboratoř, Výzkumný institut Agel, Ostrava

³ II. interní klinika &ndash, Gastroenterologické oddělení FN u sv. Anny, LF MU Brno

⁴ Katedra podpory zdraví, Fakulta sportovních studií MU Brno

Exocrine pancreatic insufficiency is a serious condition clinically manifested by signs of pancreatic malnutrition. The treatment of these

conditions is based on administration of drugs containing pancreatic enzymes of which lipase has the crucial role in the process of

digestion. Pancreatic enzymes are delivered in the form of capsules that contain microparticles containing pancreatic enzymes – amylase,

lipase, and peptidases. The microparticles are protected from possibly being inactivated by gastric hydrochloric acid by a pH-sensitive

coating that is disintegrated only at a pH of 5.0–6.0. This ensures the release of enzymes from the microparticles at the time when chyme

along with the microparticles enter the upper part of the duodenum.

The most common indication for treatment with pancreatic supplementation is chronic pancreatitis; in addition, large amounts of lipase

are administered in persons with abdominal-type cystic fibrosis, in pancreatic tumours as well as in celiac disease, diabetes mellitus, or

post-gastrectomy states.

In order for the treatment to be successful, it is necessary to administer sufficient quantities of enzymes, i.e. with each main meal 40,000–50,000

U of lipase; with other smaller meals 10,000–25,000 U of lipase, i.e. a capsule containing pancreatic enzymes is given during each meal.

The effect of treatment can be estimated by clinical data, i.e. a change in the nature and number of stools, change in body weight, or by

using a fat absorption test.

Keywords: exocrine pancreatic insufficiency, pancreatic enzymes, amylase, lipase, peptidases

Published: December 1, 2015  Show citation