J Korean Med Assoc.  2003 Feb;46(2):124-128. 10.5124/jkma.2003.46.2.124.

Use of Digestive Enzyme Preparations

• Kim KH

• KMID: 2065101
• DOI: http://doi.org/10.5124/jkma.2003.46.2.124

Abstract

The digestive enzyme preparations are one of the most widely used drugs in Korea. However, it is rather misused or abused. Pancreatic enzyme supplement is only indicated for pancreatic insufficiency, such as cystic fibrosis, chronic pancreatitis, pancreatectomized patients. Pancreatic insufficiency causes malabsorption, most commonly manifested by steatorrhea. However, malabsorption symptoms are not apparent until the pancreas secretes less than 5% of its maximal secretory capacity, Which means that the use of enzyme preparations are very limited and should be prescribed after careful functional study of the pancreas. In Korea, however, digestive enzyme preparations are OTC drugs and furthermore, laymen's organizations insist that the digestive enzymes be sold freely in supermarkets. The concept about the use of digestive enzymes should be changed, and their proper use by physicians as well as laymen must be emphasized.

Keyword

Digestant; Digestive enzymes; Pancreatic insufficiency; Malabsorption; Dysepsia

MeSH Terms

Cystic Fibrosis
Exocrine Pancreatic Insufficiency
Humans
Korea
Nonprescription Drugs
Pancreas
Pancreatitis, Chronic
Steatorrhea
Nonprescription Drugs

Reference

1. Lankisch PG. What to do when a patient with exocrine pancreatic insufficiency does not respond to pancreatic enzyme subsititution: A practical guide. Digestion. 1999. 60:97–103.

2. Lebenthal E, Rolston DDK, Holsclaw DS Jr. Enzyme therapy for pancreatic insufficiency: Present status and future needs. Pancreas. 1994. 9:1–12.

4. DiMagno EP, Go VLW, Summerskill WHJ. Relationship between pancreatic enzyme outputs and malabsorption in severe pancreatic insufficiency. New Engl J Med. 1973. 288:813–815.

5. Kraisinger M, Hochhaus G, Stecenko A, Bowser E, Hendeles L. Clinical pharmacology of pancreatic enzymes in patients with cystic fibrosis and in vitro performance of microencapsulated formulations. J Clin Pharmacol. 1994. 34:158–166.