Clinical Gastroenterology Vol.13 No.13(12)

Theme Direction of the Prescription for Gastrointestinal Tract
Title Digestive Enzyme Preparation
Publish Date 1998/12
Author Kazuya Hirakawa Shimane Health Screening Center for Adults
[ Summary ] The aim of administrating a digestive enzyme preparation is to supplement the decreased production of endogeneous digestive enzymes in patients with dyspeptic conditions. It is thought to improve various disorders contribute to dyspepsia. Diseases that need supplementary therapy with digestive enzymes are limited, although these preparations have been widely prescribed. Chronic pancreatitis is one disease in which these kinds of drugs may be used. In the advanced stages of this disease, the secretion of pancreatic enzymes, especially lipase decreases significantly. Consequently, large doses of oral pancreatic enzyme preparations, including lipase, are necessary for the improvement of fat digestion. In addition, supplementary therapy with a pancreatic enzyme preparation is used for pain relief in patients with chronic pancreatitis. This treatment is based on the presence of a luminal feedback regulation mechanism in the duodenum. Since the increase of intraduodenal protease decrease exocrine pancreatic secretion, large doses of oral pancreatic enzyme preparations, including trypsin, suppress the secretion of exocrine pancreatic emzymes. Then, decreased pancreatic secretion automatically decreases intrapancreatic duct pressure with a resulting attenuation of pancreatic pain.
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