Digestive Diseases and Sciences

, Volume 28, Issue 2, pp 97–102 | Cite as

Pain reduction by an oral pancreatic enzyme preparation in chronic pancreatitis

  • Gunnar Isaksson
  • Ingemar Ihse
Original Articles


In a double-blind study on 19 patients with the diagnosis of chronic pancreatitis, the effects of treatment with a granulated pancreatic enzyme preparation (Pankreon) were compared with those of placebo administration. One week of treatment with each preparation was preceded by one week without any medication. The patients kept daidy records of their symptoms, plotting the severity of pain on an analog scale. Weekly assessments of the mean pain level were also made by an examiner questioning the patients. Recordings of body weights and pancreas and liver laboratory tests were done weekly. Fifteen of 19 patients noted less pain during the week of treatment with pancreatic enzymes as compared to that of placebo treatment (P<0.05). The average reduction of pain, as calculated for all patients, was 30% as evaluated by both patients (P<0.01) and the examiner (P<0.05). No differences were found in other parameters examined. A possible explanation of the findings could be an effect on the intraductal pressure by intraluminal trypsin.


Enzyme Placebo Pancreatitis Trypsin Laboratory Test 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Puestow CB, Gillesby WJ: Retrograde surgical drainage of pancreas for chronic relapsing pancreatitis. Arch Surg 76:898–907, 1958Google Scholar
  2. 2.
    Arnesjö B, Ihse I, Kugelberg C, Tylén U: Pancreaticojejunostomy in chronic pancreatitis. Acta Chir Scand 141:139–148, 1975Google Scholar
  3. 3.
    Jordan GL, Strug BS, Crowder WE: Current status of pancreaticojejunostomy in the management of chronic pancreatitis. Am J Surg 133:46–51, 1977Google Scholar
  4. 4.
    Greene GM, Lyman RL: Feedback regulation of pancreatic enzyme secretion as a mechanism for trypsin inhibitor-induced hypersecretion in rats. Proc Soc Exp Biol Med 140:6–12, 1972Google Scholar
  5. 5.
    Ihse I, Lilja P: Effects of intestinal amylase and trypsin on pancreatic secretion in the pig. Scand J Gastroenterol 14:1009–1013, 1979Google Scholar
  6. 6.
    Ihse I, Lilja P, Lundquist I: Feedback regulation of pancreatic enzyme secretion by intestinal trypsin in man. Digestion 15:303–308, 1977Google Scholar
  7. 7.
    Osnes M, Hanssen LE: The influence of intraduodenal administration of pancreatic juice on the bile-induced pancreatic secretion and immunoreactive secretin release in man. Scand J Gastroenterol 15:1041–1047, 1980Google Scholar
  8. 8.
    Hotz J, Ho SB, DiMagno EP, Go VLW: The influence of duodenal tryptic activity on human pancreatic, biliary, and gastric function; no evidence for a negative feedback control. XIII Meeting of European Pancreatic Club, Krakow, 1981 (abstract)Google Scholar
  9. 9.
    DuVal MK, Enquist IF: The surgical treatment of chronic pancreatitis by pancreaticojejunostomy: An 8-year reappraisal. Surgery 50:965–969, 1961Google Scholar
  10. 10.
    Ihse I, Lilja P, Lundquist I: Intestinal concentrations of pancreatic enzymes following pancreatic replacement therapy. Scand J. Gastroenterol 15:137–144, 1980Google Scholar
  11. 11.
    Wolfson P: Surgical management of inflammatory disorders of the pancreas. Surg Gynecol Obstet 151:689–698, 1980Google Scholar
  12. 12.
    Prinz RA, Greenlee HB: Pancreatic duct drainage in 100 patients with chronic pancreatitis. Ann Surg 194:313–320, 1981Google Scholar
  13. 13.
    Bornman PC, Marks IN, Girdwood AJ, Clain JE, Narunsky L, Clain DJ, Wright JP: Is pancreatic duct obstruction or stricture a major cause of pain in chronic pancreatitis? Br J Surg 67:425–428, 1980Google Scholar
  14. 14.
    Leger L, Lenriot JP, Lemaigre G: Five to twenty year follow-up after surgery for chronic pancreatitis in 148 patients. Ann Surg 180:191–195, 1974Google Scholar
  15. 15.
    Jacobson D, Tillman R, Toskes P, Curington C: Acute and chronic feedback inhibition of pancreatic exocrine secretion in human subjects. Gastroenterology 82:1091, 1982 (abstract)Google Scholar
  16. 16.
    DiMagno EP, Malagelada JR, Go VLW, Moertel CG: Fate of orally ingested enzymes in pancreatic insufficiency. N Engl J Med 296:1318–1322, 1977Google Scholar

Copyright information

© Digestive Disease Systems, Inc. 1983

Authors and Affiliations

  • Gunnar Isaksson
    • 1
  • Ingemar Ihse
    • 1
  1. 1.Department of SurgeryUniversity HospitalLundSweden

Personalised recommendations