Nejen nemoci pankreatu a jejich terapie pankreatickými enzymy
| Title in English | Not only diseases of the pancreas and their therapy with pancreatic enzymes |
|---|---|
| Authors | |
| Year of publication | 2015 |
| Type | Article in Periodical |
| Magazine / Source | Interní medicína pro praxi |
| MU Faculty or unit | |
| Citation | |
| Field | Endocrinology, diabetology, metabolism, nutrition |
| Keywords | exocrine pancreatic insufficiency; pancreatic enzymes; amylase; lipase; peptidases |
| Description | 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. |