title: Comparative trial of Nutrizym in chronic pancreatic insufficiency.
abstract: A cross-over trial of pancreatic replacement therapy was carried out in 12 adults with chronic pancreatic insufficiency. The standard enteric-coated preparation, Pancrex V forte, was compared with Nutrizym, which has an enteric-coated core of pancreatic extract and a shell of bromelains-a mixture of proteolytic enzymes derived from the stem of the pineapple.Nutrizym was significantly more effective than Pancrex V forte in improving fat absorption, and reduced faecal weight. Protein digestion was assessed by measuring the urinary excretion of hydroxyproline after a gelatin meal. Nutrizym produced an earlier and significantly higher peak in hydroxyproline excretion than Pancrex V forte, but the cumulative effect was similar. The value of bromelains was investigated by including a period on the Nutrizym core alone. This was similar to Pancrex V forte in improving fat absorption but had less effect on protein digestion, suggesting that the beneficial effect of Nutrizym compared with Pancrex V forte was due to the added bromelains, and not to differences in enzyme content or enteric coating.
mesh_terms: D000293:Adolescent; D000328:Adult; D000681:Amylases / Q000627:therapeutic use*; D001963:Bromelains / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D005223:Fats / Q000378:metabolism; D005243:Feces; D005260:Female; D005780:Gelatin / Q000378:metabolism; D006801:Humans; D006909:Hydroxyproline / Q000652:urine; D008049:Lipase / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000188:drug therapy*; D010194:Pancreatin / Q000627:therapeutic use*; D014357:Trypsin / Q000627:therapeutic use*
chemical_list: D005223:Fats; D010194:Pancreatin; D005780:Gelatin; D001963:Bromelains; D008049:Lipase; D000681:Amylases; D014357:Trypsin; D006909:Hydroxyproline