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Vitamins, Minerals and Dietary Supplements

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Pancreatic Enzymes

What are pancreatic enzymes?

Pancreatic enzymes are a class of digestive enzymes the body uses to help digest food and cause chemical changes in foods and other substances. Pancreatic enzymes are also considered proteolytic enzymes in that their primary function is to help the body digest protein.

Pancreatic enzymes are often taken by people who suffer from indigestion that cannot be attributed to a single factor. Usually, pancreatic enzymes are taken with meals. Studies have shown that they can reduce the incidence of gas, bloating and upset stomach that often occurs following consumption of a high-fat meal. Pancreatic enzymes may also reduce the symptoms of some food allergies by helping the body to break down undigested proteins. Pancreatic enzymes may also improve the functioning of the immune system, although scientific evidence has yet to validate this claim.

How much pancreatic enzymes should I take?

The amount of pancreatic enzymes to be taken depends in large part on whether a person has been diagnosed with pancreatitis, cystic fibrosis, celiac disease, Crohn's disease, or chronic indigestion. All of these conditions may cause a person to have a deficiency of pancreatic enzymes. Many health care providers will recommend between three and four grams of pancreatic enzymes, given at a dose of 4X (four times stronger than the U.S. Pharmacopeia standard) with each meal to help people digest food. Other enzymes may also be recommended, including amylases, lipases and proteases.

What forms of pancreatic enzymes are available?

Pancreatic enzymes are typically produced by the pancreas. However, some pancreatic enzymes can be derived from certain foods. In addition, pancreatic enzymes are available as a dietary supplement, usually in pill or tablet form.

What can happen if I take too much pancreatic enzymes? Are there any interactions I should be aware of? What precautions should I take?

Some research suggests that enteric-coated pancreatic enzymes may cause a condition called fibrosing colonopathy, which can damage a child's large intestine. As a result, pancreatic enzymes should not be taken by children with cystic fibrosis unless they are under the care of a licensed health care provider. In addition, pancreatic enzymes may interact negatively with warfarin or coumadin. Patients taking this medication should avoid pancreatic enzymes. As always, make sure to consult with a licensed health care provider before taking pancreatic enzymes or any other dietary supplement or herbal remedy.

References

  • Nakamura T, Tandoh Y, Terada A, et al. Effects of high-lipase pancreatin on fecal fat, neutral sterol, bile acid, and short-chain fatty acid excretion in patients with pancreatic insufficiency resulting from chronic pancreatitis. Int J Pancreatol 1998;23:63-70.
  • Patel RS, Johlin FC Jr, Murray JA. Celiac disease and recurrent pancreatitis. Gastrointest Endosc 1999;50:823-7.
  • Powell CJ. Pancreatic enzymes and fibrosing colonopathy. Lancet 1999;354:251.
  • Suarez F, Levitt MD, Adshead J, Barkin JS. Pancreatic supplements reduce symptomatic response of healthy subjects to a high fat meal. Dig Dis Sci 1999;44:1317-21.
  • Taylor CJ, Hillel PG, Ghosal S, et al. Gastric emptying and intestinal transit of pancreatic enzyme supplements in cystic fibrosis. Arch Dis Child 1999;80:149-52.

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