Document Detail

Gastric transit and pharmacodynamics of a two-millimeter enteric-coated pancreatin microsphere preparation in patients with chronic pancreatitis.
MedLine Citation:
PMID:  9508526     Owner:  NLM     Status:  MEDLINE    
It has been suggested that enteric-coated pancreatin microsphere (ECPM) preparations with sphere sizes larger than 1.7 mm pass through the stomach at a slower rate than a meal and therefore may be less efficacious in restoring pancreatic enzyme activity than preparations with smaller sphere sizes. The aim of this study was to investigate the gastric transit profile of a 2-mm ECPM preparation in relation to that of a solid meal and to simultaneously measure enzyme activities in eight patients with pancreatic exocrine insufficiency due to chronic pancreatitis. Gastric transit was assessed by double-isotope scintigraphy. A pancake was labeled with 99mTc. A 2-mm ECPM preparation was labeled with 171Er. Intraluminal pancreatic enzyme activities were assessed during a 6-hr period with the cholesteryl-[14C]octanoate breath test (for carboxyl ester lipase activity) and the N-benzoyl-L-tyrosyl-p-aminobenzoic acid/p-aminosalicylic acid (NBT-PABA/PAS) test (for chymotrypsin activity). The ECPM preparation passed through the stomach more rapidly (median 24 min) than the pancake (median 52 min, P < 0.05). During ECPM therapy, mean cumulative 14CO2 outputs rose significantly from 30% to 70% (P < 0.05), but remained below outcomes in healthy volunteers. Mean cumulative plasma PABA concentrations rose significantly from 46% to 87% (P < 0.05) and were not significantly different from outcomes in healthy volunteers. In chronic pancreatitis, a 2-mm ECPM preparation does not pass through the stomach more slowly than a solid meal, but in fact faster. Digestion of ester lipids and proteins showed an improvement to subnormal and normal levels, respectively.
M J Bruno; J J Borm; F J Hoek; B Delzenne; A F Hofmann; J J de Goeij; E A van Royen; D J van Leeuwen; G N Tytgat
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  43     ISSN:  0163-2116     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  1998 Jan 
Date Detail:
Created Date:  1998-03-13     Completed Date:  1998-03-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  203-13     Citation Subset:  AIM; IM    
Department of Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
4-Aminobenzoic Acid / blood
Breath Tests
Cholesterol Esters / analysis
Chronic Disease
Gastrointestinal Agents / administration & dosage*,  pharmacokinetics*
Gastrointestinal Transit
Middle Aged
Pancreatin / administration & dosage*,  pharmacokinetics*
Pancreatitis / enzymology,  metabolism*
Stomach / metabolism*
Tablets, Enteric-Coated
Technetium / diagnostic use
Reg. No./Substance:
0/Cholesterol Esters; 0/Gastrointestinal Agents; 0/Tablets, Enteric-Coated; 1182-42-9/cholesteryl octanoate; 150-13-0/4-Aminobenzoic Acid; 7440-26-8/Technetium; 8049-47-6/Pancreatin

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