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Pancreas Substance

Also known as: Pancreatic enzymes, Amylase, Lipase, Trypsin, Pancreatin, Pancreas substance

Overview

Pancreatic enzymes are substances produced by the pancreas essential for the digestion of macronutrients, specifically carbohydrates, fats, and proteins. These enzymes include amylase, lipase, and trypsin, each serving a crucial role in breaking down food components into absorbable forms. Supplementation with pancreatic enzymes is commonly utilized in cases of exocrine pancreatic insufficiency (EPI), a condition often resulting from chronic pancreatitis, cystic fibrosis, or pancreatic cancer. The supplements can be derived from animal sources, particularly porcine pancreas, or synthesized through microbial fermentation. Available in both enteric-coated and non-enteric-coated forms, enteric-coated versions are designed to survive the acidic environment of the stomach, ensuring enzyme efficacy upon reaching the small intestine. While research indicates moderate evidence supporting their use in improving nutrition in patients with EPI, findings related to pain relief remain mixed.

Benefits

Pancreatic enzyme supplements primarily help improve nutrient absorption, specifically increasing fat and nitrogen absorption, which are critical for individuals diagnosed with EPI, especially those suffering from chronic pancreatitis. A systematic review evidenced significant improvements in nutritional parameters within weeks to months of use, demonstrating a strong evidence base for enhancing overall nutritional status. Furthermore, while there is some anecdotal evidence of reducing abdominal pain and improving quality of life, outcomes regarding pain relief are variable and generally considered weaker. Overall, the strongest benefits are observed in correcting malnutrition and associated deficiencies, with moderate evidential strength for impacting quality of life through better digestion.

How it works

Pancreatic enzyme supplements work by replenishing enzymes that are deficient due to pancreatic dysfunction. These enzymes, once administered, facilitate the digestion and absorption of carbohydrates, fats, and proteins in the gastrointestinal tract. The enzymes act by breaking down food into smaller molecules that can be easily absorbed by the intestinal wall. The enteric coating on many supplements helps protect these enzymes from inactivation by gastric acid, thus enhancing their bioavailability and effectiveness once they reach the small intestine.

Side effects

Pancreatic enzyme supplements are generally considered safe when used as directed, though some individuals may experience adverse effects. Common side effects, occurring in more than 5% of users, include gastrointestinal discomfort, such as diarrhea, constipation, or upset stomach. Uncommon side effects (1-5%) may include allergic reactions, which could cause symptoms like itching or rash. Rarely (less than 1%), severe allergic reactions may occur, necessitating immediate medical attention. Caution is advised for individuals with known hypersensitivity to pork-derived products. Additionally, these supplements may interact with certain medications, particularly antacids, necessitating a review of concurrent medications by a healthcare professional. Patients with severe allergies or any underlying conditions should consult a healthcare provider prior to use.

Dosage

Dosing for pancreatic enzyme supplements varies based on the severity of enzyme deficiency and individual dietary needs. A commonly recommended dosage range is between 30,000 to 90,000 lipase units per meal, adjusted based on clinical response and nutritional status. Supplements should be taken with meals to optimize digestion and improve efficacy. There are no well-defined upper safety limits, but high doses can increase the risk of gastrointestinal side effects. For best results, enteric-coated formulations are advised to protect enzymes from gastric acid, thereby enhancing absorption in the intestine. Adequate hydration is also important to facilitate the functionality of the enzymes.

FAQs

How should pancreatic enzyme supplements be taken?

They should be taken with meals to maximize their digestive benefits.

Are pancreatic enzyme supplements safe?

Generally safe, but they may cause gastrointestinal upset in some individuals.

When is the best time to take them?

They are best administered during meals to aid in digestion.

What results can I expect?

Improved nutritional status and potentially reduced gastrointestinal symptoms.

Can they relieve pain from chronic pancreatitis?

They are not effective for pain relief when used alone.

Research Sources

https://pubmed.ncbi.nlm.nih.gov/27446871/ – A systematic review and meta-analysis of 17 randomized controlled trials highlighted that pancreatic enzyme replacement therapy (PERT) significantly improves nutritional absorption and may have beneficial impacts on abdominal pain in patients with chronic pancreatitis, although significant heterogeneity exists among studies.
https://pubmed.ncbi.nlm.nih.gov/25803695/ – This systematic review analyzed five studies and found that pancreatic enzyme supplementation did not significantly relieve abdominal pain in patients with chronic pancreatitis, suggesting a need for further research in this exploration of symptom management.
https://onlinelibrary.wiley.com/doi/10.1155/2016/8541839 – A review focusing on enteral nutrition noted its benefits in acute pancreatitis but emphasized the lack of comparative data on different pancreatic enzyme formulations, reinforcing the necessity for robust comparative studies.