Enzyme Preparations of the Pancreas without Enteric Coating: Whether they are Used Today?
Journal Title: Гастроентерологія - Year 2014, Vol 3, Issue 53
Abstract
Introduction. For the treatment of exocrine pancreatic insufficiency (EPI) it is recommended enzyme replacement therapy with high-dose enteric-coated preparations. In this regard, the question arises about the rationale of clinical application of the older low-dose non enteric-coated enzyme preparations (as a reference drug served Mezim® forte). Results. A number of anatomical and physiological characteristics and active use of suppressants of gastric secretion — proton pump inhibitors, antacids (sodium bicarbonate) — allows significantly to increase the «survival» of pancreatic enzymes that do not contain enteric coating in gastric juice and their delivery to the duodenum. This formulation is used for the relief of pain in case of chronic pancreatitis (enteric-coated preparations are uneffective). It was proposed to use a combination of two dosage forms — enteric-coated and non enteric-coated — for more effective therapy EPI. In functional diseases of the gastrointestinal tract (irritable bowel syndrome with functional disorders of the pancreas, functional dyspepsia) non enteric-coated enzyme preparations speeds recovery of patients. In inflammatory bowel disease (ulcerative colitis, Crohn’s disease) and chronic obstructive pulmonary disease, this formulation increases the duration of remission, and in case of inflammatory bowel disease — also the quality of life during remission. Non enteric-coated enzyme preparations are used in a number of other diseases associated with maldigestion/malabsorption. Additionally, they are used for the gradual cessation of therapy by high-dose enzyme preparations. They also find application for the correction of EPI during snacks and some gaps in the diet. Financial sales figures indicate a high demand for low-dose non enteric-coated enzyme preparations (Mezim® forte). Conclusions. Low-dose non enteric-coated enzyme preparations are still widely used in current clinical practice.
Authors and Affiliations
A. V. Savustyanenko
Keywords
Related Articles
- EP ID EP225087
- DOI -
- Views 83
- Downloads 0
State Institution «Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine», Dnipropetrovsk, Ukraine
The analysis of the prevalence and morbidity of obesity in children and adolescents in Ukraine for a period of 2010–2013 was conducted. Obesity reaches 17.2 % among endocrine diseases, which take 4th place in the structu...
Using the Quantitative Determination of HbsAg to Monitor Antiviral Therapy of Chronic HBV-Infection
Currently, the main unresolved issue in monitoring antiviral therapy of chronic HBV-infection is the lack of clear predictors of sustained virologic response to treatment. These predictors would allow early identificatio...
Syndrome of Portal Hypertension: Possibilities of Modern Diagnosis
The article deals with the possibilities of modern medicine in the diagnosis of portal hypertension syndrome. Diagnostic criteria for ultrasound, endoscopic, radiographic, angiographic and laboratory techniques in the ev...
Pancreatic Diseases as One of the Main Problems in Gastroenterology and Abdominal Surgery (Modern Epidemiology)
The analysis of the data of Center for Medical Statistics of Ministry of Healthcare of Ukraine for 8 years (2006–2013) has been carried out. We have analyzed the parameters of prevalence, incidence and clinical cases of...
The Role of Enteropathogenic E.coli in the Development and Progression of Chronic Non-Ulcerative Colitis
Objective. The analysis of the literature has shown that in patients with chronic non-ulcerative colitis, there were isolated E.coli that cause dysentery-like, cholera-like diseases and escherichioses. Thus, the aim of o...