Pancreatic Enzymes: Definition, Enzyme Supplements, Uses, Mechanism of Action, Side Effects and Interactions

They are natural chemical compounds that the pancreas secretes and whose function is to break down proteins, fats and carbohydrates.

They help maintain weight, neutralize stomach acid, and also promote nutrient absorption .

A normally functioning pancreas secretes approximately 64 ounces of fluid daily into the duodenum.

Pancreas enzyme replacement therapy is indicated for people who do not produce adequate enzymes and therefore cannot properly digest food.

Examples of conditions characterized by pancreatic enzyme deficiencies include cystic fibrosis, chronic pancreatitis, pancreatic cancer, pancreatic resection, such as the Whipple procedure (pancreaticoduodenectomy), or a total pancreatectomy.

Pancreatic enzyme products are generally obtained from the pancreas of pigs, and the pancreas of cows.

The pancreas is an organ in animals and humans that produces chemicals such as amylase, lipase, and protease, which are necessary for proper digestion.

Uses of pancreatic enzymes

Pancreatic enzymes for food applications

Pancreatic enzymes are widely used in food processing as seasonings and flavorings in the manufacture of sauces, for the aroma in cheese and other dairy products, to improve the texture of fish products, as a meat tenderizer, in the manufacture of hypoallergenic foods among others.

Pancreatic enzymes for biological research.

Protein sequencing

Trypsin is commonly used in proteomics in biological research experiments to hydrolyze proteins, for mass spectrometry analysis, or to concentrate proteins and purify them from various contaminants.

Trypsin preferentially hydrolyzes bonds whose carboxyl groups are contributed by lysine (Lys) or arginine (Arg).

Diagnostics

Trypsin has application in the diagnosis of diseases due to its activity in the production of polyclonal antibodies that are ideal for use in assays as second-stage antigen detectors.

Cell culture

Trypsin is used in in vitro cell culture, in the cell harvesting process, and to dissociate dissected cells.

Pancreatic Enzymes for OTC Pharmaceutical Applications

They are most often used as digestive aids, but they are also very effective in other applications, including pharmaceutical and therapeutic products such as:

  • Nutracéuticos.
  • Antibacterial drugs.
  • Anti-inflammatories.
  • Anticoagulants
  • Topical treatments for burns and wounds.
  • Exfoliating agents and oral hygiene products.

Proteolytic enzymes are often used in drug development for their participation in specific biological processes, such as:

  • Peptide production.
  • Production of polyclonal and monoclonal antibodies for the development of drugs and vaccines against cancer.

Replacement therapies

Within the pharmaceutical industry, pancreatic enzyme replacement therapies have been found:

Effective for:

This type of therapy seems to improve digestion problems due to a disorder of the pancreas (pancreatic insufficiency), improving the absorption of fats, proteins in those people who are not able to digest food properly.

Usually their pancreas has been removed or they have pancreatitis or cystic fibrosis.

Possibly effective for:

The accumulation of fat in the liver in people who drink little or no alcohol (nonalcoholic fatty liver disease).

Nonalcoholic fatty liver disease sometimes occurs in people who have had their pancreas removed.

Research shows that taking a prescription pancreatic enzyme drug can help prevent nonalcoholic fatty liver disease in these people.

While some research shows that over-the-counter pancreatic enzyme products can also be beneficial, it is too early to recommend them.

Insufficient evidence to:

VIH / PAGE

Fat digestion is sometimes a problem in people with HIV / AIDS. Some initial research shows that taking prescription pancreatic enzyme products may help with fat digestion in some children with HIV / AIDS.

Pancreatic cancer

Some research shows that taking a prescription drug with pancreatic enzymes can increase body weight in people with pancreatic cancer.

But other research shows that taking a pancreatic enzyme product does not improve nutritional status, body weight, or survival in people with pancreatic cancer.

Pancreatic enzyme products may only be of benefit in people with pancreatic cancer who cannot digest food properly.

More evidence is needed to rate the effectiveness of pancreatic enzyme products for these uses.

Signs and symptoms of insufficient pancreatic enzymes

People who do not produce pancreatic enzymes experience malabsorption. Signs of malabsorption include:

  • Pale stools (bowel movements) that are not easily passed.
  • Food intake and good appetite but continued weight loss is observed.
  • Large foul-smelling stools, accompanied by mucus and a greasy appearance in the upper part of the water in the well.
  • Bowel movement with flatulence, with excessive gas
  • Abdominal pain with bloating or bloating after eating.

Steatorrhea, is the presence of excess fat in the stool, is common in people with pancreatic enzyme deficiencies. These feces float on water, have an oily appearance, and can be very smelly.

Composition of enzyme supplements

Most pancreatic enzyme supplements contain a blend of digestive enzymes including lipase, protease, and amylase that are derived from the porcine pancreas.

The function of lipase together with the bile of the liver is to break down fat molecules and prepare them so that they can be absorbed and used by the body.

Lipase deficiency can cause diarrhea and / or fatty stools.

Amylase for its part transforms carbohydrates (starch) into sugars so that they are then more easily absorbed by the body.

Amylase deficiency can cause diarrhea due to the effects of undigested starch in the colon.

Protease transforms proteins. This enzyme helps keep the intestine free of parasites such as bacteria, yeast, and protozoa.

Lack of protease can cause allergies or the formation of toxic substances due to incomplete digestion of proteins and an increased risk of intestinal infections.

Mechanism of action

Pancreatic enzyme products contain amylase, lipase, and protease, which aid in the digestion of food.

Dose

The pancreatic enzyme is usually started with a low dose and gradually increased if symptoms do not resolve.

It is best to start with the smallest possible dose and adjust the dose according to the patient’s response.

The amount of pancreatic enzymes required will vary with the amount of food eaten, and may need to be increased for larger meals.

Healthcare providers prescribe pancreatic enzyme products for digestion problems due to a disorder of the pancreas, and the doses administered are units of lipase.

Lipase is one of the chemicals in pancreatin that helps with digestion.

The starting dose in adults is usually 500 to 1,000 lipase units per kilogram of body weight with each meal, up to a maximum of 2,500 lipase units per kg per meal or 4,000 lipase units per gram of fat per day.

Amounts greater than 2500 lipase units per kg per meal are prescribed only if medically necessary.

Most adults take 1 or 2 capsules per meal. These enzymes are extracted from the glands of the pig pancreas and there is currently no alternative to the use of pork products.

However, it is important to know that for those who may have religious objections to the ingestion of pork products, religious organizations have given a special dispensation to allow these products to be a medicine.

In nonalcoholic fatty liver disease, a specific delayed-release prescription pancreatic enzyme product 1800 mg daily has been used for 6 to 12 months.

Presentation

Pancreatic enzyme replacement therapy comes in different formulations and dosages. Enzyme preparations are dosed by lipase content (5000 units, 10,000 units).

Pancreatic enzyme replacements are dosed in capsule form.
Inside each capsule are many small granules that contain digestive enzymes.

Each granule is covered with a special enteric coating that allows the granules to dissolve in the small intestine. Digestive enzymes are released in the small intestine to aid in the digestion of food.

The most popular patented drugs come in capsules:

  • 10,000 capsules (mainly used in pediatrics)
  • 25,000 capsules
  • 40,000 capsules.

Side effects

Prescription pancreatic enzyme products are probably safe when taken by mouth under the guidance of a healthcare provider.

Side effects can include high or low blood sugar, stomach pain, abnormal bowel movements, gas, headache, or dizziness.

Taking prescription pancreatic enzyme products in amounts greater than prescribed is not safe.

Higher doses can increase your chance of having a certain rare bowel disorder.

Cautions and warnings

Pregnancy and breastfeeding

There is not enough reliable information to know if pancreatic enzyme products are safe to use during pregnancy or while breastfeeding. Avoid use, unless directed by a healthcare professional.

Diabetes

Pancreatic enzyme products can make it difficult for some people with diabetes to control their blood sugar.

You should monitor your blood sugar carefully and watch for signs of low blood sugar (hypoglycemia) or high blood sugar (hyperglycemia) if you have diabetes and use pancreatic enzyme products. .

Interactions

Acarbose (Precose, Prandase) is used to help treat type 2 diabetes and they work by slowing down how quickly food breaks down. By helping the body break down food, pancreatin may decrease the effectiveness of these medications.