Pancreatin

Pancreatic Enzyme Replacement

The Pancreas

The Pancreas comprises one part of the digestive system and is responsible for secreting specialized enzymes during digestion that aid the breakdown of chyme into various components. These notable enzymes are mentioned a number of times within this very blog and they are;

  • Amylase
  • Lipase
  • and Protease
As mentioned earlier, pancreatic enzyme replacement therapy is a viable treatment for those who have trouble assimilating nutrients and have moderate to severe digestive dysfunction. While there are various conditions that can cause pancreatic enzyme replacement therapy to be necessitated, one condition of particular interest (And of great relevance to some) is in the treatment of digestive dysfunction caused via cystic fibrosis.

 

Pancreatic Enzyme Replacement Therapy in Cystic Fibrosis

Under normal circumstances, upon eating a meal, at a particular point in digestion the pancreas secretes the three aforementioned enzymes through the pancreatic duct and into the chyme passing through the duodenum. At this point the enzymes fulfill their purpose by binding to the allosteric sites present in the particular molecule of food for which they fit into (e.g. Protein/Fat/Carbs etc). In the case of a cystic fibrosis patient undergoing pancreatic enzyme replacement therapy however, the normal mechanisms of digestion often come to a halt at the point at which the pancreas is due to engage in its part in digestion. Instead of having a clear passage through the pancreatic duct and into the duodenum, the duct becomes blocked by mucus. The mucus is the characteristic manifestation of cystic fibrosis and is caused by an abnormal transportation of sodium and chloride across the epithelium resulting in the classic mucus secretions. The consequence of these blockages is the malabsorption of food. This occurs because the necessary enzymes do not reach the duodenum to engage the chyme and so they pass through the duodenum and into the small intestine undigested. Ultimately this leads to malnurishment as the foods being consumed are not being broken down adequately and so assimilation becomes impaired. This invariably has a profoundly negative effect on the patient and so compensation for this shortfall in digestion must be achieved for adequate digestion to take place. Fortunately the answer lies in pancreatic enzyme replacement therapy.

Pancreatic enzyme replacement therapy is just as the name suggests. It is the provision of the pancreatic digestive enzymes normally secreted by the pancreas in an orally administered form. Usually pancreatic enzyme replacement therapy comes in enteric coated capsules, which means the enzymes survive the initial stages of digestion and make it to the small intestine where they are released from the capsule and may begin their enzymatic activity on any food that is down there. All the patient need do to ensure the improvement of their digestion is to take these capsules with their meals and let the pancreatic enzyme replacement therapy undertake their own digestive shortfalls. Pancreatic enzyme replacement therapy is common treatment for this condition and its safety and efficacy record is outstanding.

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