| Management of chronic pancreatitis. Focus on enzyme replacement therapy. | |
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MedLine Citation:
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PMID: 2702247 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The goals of treatment with pancreatic extracts in patients with chronic relapsing pancreatitis are twofold: pain relief and control of maldigestion caused by exocrine pancreatic insufficiency. Experience with the use of pancreatic enzymes for analgesic purposes suggests that the less severe the pain, the greater the analgesic effect of these enzymes. However, the number of trials, as well as the number of patients treated, is fairly small and more studies in larger patient populations are needed. The use of pancreatic enzymes for maldigestion owing to exocrine pancreatic insufficiency which is secondary to chronic pancreatitis, pancreatectomy, cystic fibrosis, or GI bypass surgery incurs several problems. These problems are primarily caused by gastric inactivation of the enzymes, low enzyme activity of many commercial preparations and/or poor patient compliance. Treatment with conventional enzyme products (powdered extracts, enteric-coated tablets or capsules) has been disappointing. At best, results were inconsistent, showing a high degree of individual variation. The introduction of enzyme preparations in the form of pH-sensitive enteric-coated microspheres in hard gelatin capsules represents a significant advance. These microspheres are superior to conventional enzyme preparations in improving the symptoms of pancreatic insufficiency, particularly steatorrhea, where low doses of microspheres are as effective as large doses of conventional enzyme preparations. Steatorrhea, however, is rarely completely resolved. In cases refractory to therapy, treatment with the combination of pH-sensitive enteric-coated microspheres and H2-antagonists or prostaglandins has met with some success. |
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Authors:
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G Dobrilla |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: International journal of pancreatology : official journal of the International Association of Pancreatology Volume: 5 Suppl ISSN: 0169-4197 ISO Abbreviation: Int. J. Pancreatol. Publication Date: 1989 |
Date Detail:
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Created Date: 1990-11-15 Completed Date: 1990-11-15 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 8703511 Medline TA: Int J Pancreatol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 17-29 Citation Subset: IM |
Affiliation:
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Division of Gastroenterology, General Regional Hospital, Bolzano, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Chronic Disease Enzymes / adverse effects, therapeutic use Humans Pancreas / enzymology Pancreatic Extracts / adverse effects, therapeutic use Pancreatitis / drug therapy*, enzymology |
| Chemical | |
Reg. No./Substance:
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0/Enzymes; 0/Pancreatic Extracts |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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