Therapy of pancreatogenic steatorrhoea: does acid protection of pancreatic enzymes offer any advantage?

Abstract

Pancreatic enzyme replacement may fail to achieve a beneficial effect because of enzyme inactivation by gastric acid. In this controlled randomized study, 8 hospitalized patients with severe exocrine pancreatic insufficiency and considerable steatorrhoea (greater than 15 g faecal fat/day) were treated with a conventional pancreatic enzyme preparation (Pankreon 700; 3 X 3 dragees daily), with (300 mg) and without cimetidine before meals, and with a new pH-sensitive enzyme preparation (Kreon; 3 X 6 capsules daily) comprising acid-protected granules. Both conventional enzyme replacement plus cimetidine, and acid-protected pancreatin were significantly (p less than 0.05) more effective than conventional enzyme therapy alone. Since both regimens are equally potent in overcoming gastric acid-induced enzyme inactivation, it is concluded that therapy with acid-protected pancreatin may simplify and improve treatment of exocrine pancreatic insufficiency in the presence of gastric hyper- or normo-acidity.

• Authors: P G Lankisch, B Lembcke, B Göke, W Creutzfeldt
• Journal: Zeitschrift fur Gastroenterologie (Z Gastroenterol) Vol. 24 Issue 12 Pg. 753-7 (Dec 1986) ISSN: 0044-2771 [Print] Germany
• PMID: 3548109 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Cimetidine
• Pancreatin
• Lipase

Topics

• Celiac Disease (drug therapy)
• Chronic Disease
• Cimetidine (therapeutic use)
• Clinical Trials as Topic
• Drug Therapy, Combination
• Exocrine Pancreatic Insufficiency (drug therapy)
• Female
• Humans
• Lipase (therapeutic use)
• Male
• Pancreatin (therapeutic use)
• Pancreatitis (complications)
• Random Allocation