To assess the fate and efficacy of orally ingested enzymes in pancreatic insufficiency, we administered pancreatin to six patients by two schedules--eight tablets with a standard meal or two tablets hourly--and in six normal controls, quantified duodenal enzyme activity and related inactiviation of ingested enzymes to gastric and duodenal pH; in the six patients we measured malabsorption by fecal balance studies. Postprandially, gastric pH was similar in health and pancreatic insufficiency, and below 4 after 40 minutes. Duodenal pH in pancreatic insufficiency declined to approximately 4 beyond 100 minutes--lower than in health (P less than 0.05). Approximately 22 per cent and 8 per cent of trypsin and lipase activity ingested with either schedule was delivered to the ligament of Treitz. Prandial was as effective as hourly administration in decreasing steatorrhea and perhaps more effective in abolishing azotorrhea, and since it is also more convenient, we recommend it.
Intraluminal pH of duodenum and jejunum in fasting subjects with normal and abnormal gastric or pancreatic function
pH and concentration of pancreatic enzymes in aspirates from the human duodenum during digestion of a standard meal in patients with pancreatic diseases
Clinical pharmacology of pancreatic enzymes in patients with cystic fibrosis and in vitro performance of microencapsulated formulations
Studies on the quality of pancreatic preparations: enzyme content, prospective bioavailability, bile acid pattern, and contamination with purines
Use of famotidine in severe exocrine pancreatic insufficiency with persistent maldigestion on enzymatic replacement therapy. A long-term study in cystic fibrosis
Influence of exocrine pancreatic insufficiency on the intraluminal pH of the proximal small intestine
Use of pancreatic Schilling test to determine efficiency of pancreatic enzyme delivery in pancreatic insufficiency
Comparative effects of adjuvant cimetidine and omeprazole during pancreatic enzyme replacement therapy
CREON (Pancrelipase Delayed-Release Capsules) for the treatment of exocrine pancreatic insufficiency
Effect of bacterial or porcine lipase with low- or high-fat diets on nutrient absorption in pancreatic-insufficient dogs
Signs and symptoms of pancreatic cancer: a population-based case-control study in the San Francisco Bay area
Enzyme replacement therapy of exocrine pancreatic insufficiency in man. Relations between in vitro enzyme activities and in vivo potency in commercial pancreatic extracts
Comparative effects of antacids, cimetidine and enteric coating on the therapeutic response to oral enzymes in severe pancreatic insufficiency
Efficacy of lower than standard doses of pancreatic enzyme supplementation therapy during acid inhibition in patients with pancreatic exocrine insufficiency
Twenty-four hour ambulatory gastric and duodenal pH profiles in cystic fibrosis: effect of duodenal hyperacidity on pancreatic enzyme function and fat absorption
Retrospective analysis to investigate the effect of concomitant use of gastric acid-suppressing drugs on the efficacy and safety of pancrelipase/pancreatin (CREON®) in patients with pancreatic exocrine insufficiency
The treatment of malabsorption in cystic fibrosis with pancreatic extracts and inhibition of gastric acidity by antacids and cimetidine
Comparative trial of viokase, pancreatin and Pancrease pancrelipase (enteric coated beads) in the treatment of malabsorption in cystic fibrosis
Influence of antacid and formulation on effectiveness of pancreatic enzyme supplementation in cystic fibrosis
Effect of intrajejunal acidity on aqueous phase bile acid and lipid concentrations in pancreatic steatorrhoea due to cystic fibrosis
Conjugated bile acids in serum and secretions in response to cholecystokinin/secretin stimulation in children with cystic fibrosis
Effect of cimetidine on enzyme inactivation, bile acid precipitation, and lipid solubilisation in pancreatic steatorrhoea due to cystic fibrosis
Acid resistant lipase as replacement therapy in chronic pancreatic exocrine insufficiency: a study in dogs
Monitoring enzyme replacement treatment in exocrine pancreatic insufficiency using the cholesteryl octanoate breath test
Enteric coated microspheres of pancreatin in the treatment of cystic fibrosis: comparison with a standard enteric coated preparation
Lingual lipase in cystic fibrosis. Quantitation of enzyme activity in the upper small intestine of patients with exocrine pancreatic insufficiency
Mechanisms of lipid malabsorption in Cystic Fibrosis: the impact of essential fatty acids deficiency
Gastric function in children with cystic fibrosis: effect of diet on gastric lipase levels and fat digestion
Delayed release pancrelipase for treatment of pancreatic exocrine insufficiency associated with chronic pancreatitis
Safety and tolerability of a new formulation of pancrelipase delayed-release capsules (CREON) in children under seven years of age with exocrine pancreatic insufficiency due to cystic fibrosis: an open-label, multicentre, single-treatment-arm study
Variant of the Thermomyces lanuginosus lipase with improved kinetic stability: a candidate for enzyme replacement therapy
Critical examination of therapeutic efficacy of a pH-sensitive enteric-coated pancreatic enzyme preparation in treatment of exocrine pancreatic insufficiency secondary to cystic fibrosis
The daily practice of pancreatic enzyme replacement therapy after pancreatic surgery: a northern European survey: enzyme replacement after surgery
Chronic pancreatitis, a comprehensive review and update. Part I: epidemiology, etiology, risk factors, genetics, pathophysiology, and clinical features
Effect of omeprazole on changes in gastric and upper small intestine pH levels in patients with chronic pancreatitis
Study to compare the enzyme activity, acid resistance and dissolution characteristics of currently available pancreatic enzyme preparations
A comparison of enteric coated microspheres with enteric coated tablet pancreatic enzyme preparations in cystic fibrosis. A controlled study
Treatment of pancreatic degenerative atrophy with raw pancreas homogenate and various enzyme preparations
Clinical pharmacology for pediatricians. I. Pancreatic enzyme preparations, with special reference to enterically coated microspheres of pancrelipase
Expression of active recombinant human gastric lipase in Nicotiana benthamiana using the CPMV-HT transient expression system
Malabsorption blood test: Assessing fat absorption in patients with cystic fibrosis and pancreatic insufficiency
Assessment of weight loss, food intake, fat metabolism, malabsorption, and treatment of pancreatic insufficiency in pancreatic cancer
Pancreatic enzyme supplementation as acid-resistant microspheres versus enteric-coated granules in cystic fibrosis. A double placebo-controlled cross-over study
Effect of the administration schedule on the therapeutic efficacy of oral pancreatic enzyme supplements in patients with exocrine pancreatic insufficiency: a randomized, three-way crossover study
In vitro comparative study of three pancreatic enzyme preparations: dissolution profiles, active enzyme release and acid stability
Increased postprandial responses of GLP-1 and GIP in patients with chronic pancreatitis and steatorrhea following pancreatic enzyme substitution
Carboxyl ester lipase (bile salt-stimulated lipase), colipase, lipase, and phospholipase A2 levels in pancreatic enzyme supplements
Ranitidine compared with the dimethylprostaglandin E2 analogue enprostil as adjunct to pancreatic enzyme replacement in adult cystic fibrosis
Circadian pancreatic enzyme pattern and relationship between secretory and motor activity in fasting humans
Infant digestion physiology and the relevance of in vitro biochemical models to test infant formula lipid digestion
Treatment of steatorrhoea in cystic fibrosis: a comparison of enteric-coated microspheres of pancreatin versus non-enteric-coated pancreatin and adjuvant cimetidine
The use of a synthetic prostaglandin E1 analogue (misoprostol) as an adjunct to pancreatic enzyme replacement in cystic fibrosis
Effects of pancreatic digestive enzymes, sodium bicarbonate, and a proton pump inhibitor on steatorrhoea caused by pancreatic diseases
Enzyme substitution in chronic pancreatitis: effects on clinical and functional parameters and on the hydrogen (H2) breath test
Adenovirus-mediated human pancreatic lipase gene transfer to rat bile: gene therapy of fat malabsorption
Pancreatic enzyme replacement therapy. Importance of gastric acid secretion, H2-antagonists, and enteric coating
Fate of orally ingested enzymes in pancreatic insufficiency: comparison of two pancreatic enzyme preparations
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