Effects of pancreatic digestive enzymes, sodium bicarbonate, and a proton pump inhibitor on steatorrhoea caused by pancreatic diseases.
Forty-five patients with pancreatic steatorrhoea (27 with calcified pancreatitis, 13 with non-calcified pancreatitis, two with pancreaticoduodenectomy, one with total pancreatectomy, and two with pancreatic cancer) were divided into four groups and given the following medication for 2 to 4 weeks: 4 to 6 g/day of sodium bicarbonate (group I); 9 g/day of high-lipase pancreatin (lipase, 56,600 U/g, Fédération Internationale Pharmaceutique (FIP); group II); 12 to 24 tablets or 9.0 g of commercial pancreatic enzyme preparations (group III); or 50 mg of omeprazole (group IV). Faecal fat excretion was evaluated before and after drug administration. Faecal fat excretion was reduced by 2.9 g (range, 1.7 to 5.0 g) in group I; 8.8 g (range, 2.9 to 39.9 g) in group II; 10.8 g (range, 2.3 to 21.8 g) in group III; and 4.3 g (range, 3.6 to 5.6 g) in group IV. The pancreatic digestive enzyme preparation was more effective than sodium bicarbonate and agents that raise the pH of the upper small intestine (such as proton-pump inhibitors) in reducing faecal fat excretion. The results indicate that all of the preparations used are effective against mild pancreatic steatorrhoea. If the condition is more advanced, however, a massive dosage of pancreatic digestive enzyme and possibly the combined use of an agent to raise the pH of the upper small intestine are likely to be effective.
Nakamura
T
T
Third Department of Internal Medicine, Hirosaki University School of Medicine, Aomori, Japan.
Takebe
K
K
Kudoh
K
K
Ishii
M
M
Imamura
K
K
Kikuchi
H
H
Kasai
F
F
Tandoh
Y
Y
Yamada
N
N
Arai
Y
Y
D000328:Adult; D000368:Aged; D002446:Celiac Disease / Q000188:drug therapy* / Q000209:etiology; D004041:Dietary Fats / Q000494:pharmacology; D005243:Feces / Q000737:chemistry; D006801:Humans; D008875:Middle Aged; D010179:Pancreas / Q000201:enzymology*; D010182:Pancreatic Diseases / Q000150:complications*; D054328:Proton Pump Inhibitors; D017693:Sodium Bicarbonate / Q000627:therapeutic use*
D004041:Dietary Fats; D054328:Proton Pump Inhibitors; D017693:Sodium Bicarbonate