ISSN:
1573-2568
Keywords:
CHRONIC PANCREATITIS
;
EXOCRINE PANCREATIC INSUFFICIENCY
;
ENZYME REPLACEMENT THERAPY
;
PANCREATIN
;
ENTERIC-COATED MICROSPHERE THERAPY
;
ERBIUMOXIDE
;
GASTRIC EMPTYING
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract It has been suggested that enteric-coatedpancreatin microsphere (ECPM) preparations with spheresizes larger than 1.7 mm pass through the stomach at aslower rate than a meal and therefore may be less efficacious in restoring pancreatic enzymeactivity than preparations with smaller sphere sizes.The aim of this study was to investigate the gastrictransit profile of a 2-mm ECPM preparation in relation to that of a solid meal and to simultaneouslymeasure enzyme activities in eight patients withpancreatic exocrine insufficiency due to chronicpancreatitis. Gastric transit was assessed bydouble-isotope scintigraphy. A pancake was labeled with99mTc. A 2-mm ECPM preparation was labeledwith 171Er. Intraluminal pancreatic enzymeactivities were assessed during a 6-hr period with thecholesteryl-[14C]octanoate breath test (for carboxyl ester lipaseactivity) and the N -benzoyl-L-tyrosyl-p aminobenzoicacid/p-aminosalicylic acid (NBT-PABA/PAS) test (forchymotrypsin activity). The ECPM preparation passedthrough the stomach more rapidly (median 24 min) thanthe pancake (median 52 min, P 〈 0.05). During ECPMtherapy, mean cumulative 14CO2outputs rose significantly from 30% to 70% (P 〈0.05), but remained below outcomes in healthy volunteers. Mean cumulative plasmaPABA concentrations rose significantly from 46% to 87%(P 〈 0.05) and were not significantly different fromoutcomes in healthy volunteers. In chronic pancreatitis, a 2-mm ECPM preparation does not pass throughthe stomach more slowly than a solid meal, but in factfaster. Digestion of ester lipids and proteins showed animprovement to subnormal and normal levels,respectively.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1018813229334
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