Advertisement

Substitutionstherapie mit Pankreasenzym — wann ist sie essentiell und wie ist sie durchzuführen?

  • W. F. Caspary
Conference paper

Zusammenfassung

Die wichtigsten Nahrungsbestandteile des Menschen sind Kohlenhydrate, Protein und Fett. Beim Assimilationsprozeß unterscheiden wir zwischen einer digestiven und einer resorptiven Phase der Verdauung.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. 1.
    Adler G (1988) Enzymsubstitution zur Behandlung der Schmerzen bei chronischer Pankreatitis. Bedeutung der Feedbackregulation für die Pankreassekretion. Dtsch Med Wochenschr 113 :1075–1079PubMedCrossRefGoogle Scholar
  2. 2.
    Becker HD, Caspary WF (Hrsg) (1980) Postvagotomy and postgastrectomy syndromes. Springer, Berlin Heidelberg New YorkGoogle Scholar
  3. 3.
    Boivin M, Lanspa SJ, Zinsmeister AR, Go VLW, DiMagno EP (1990) Are diets associated with different rates of human interdigestive and postprandial pancreatic secretion? Gastroenterology 99:1763–1771PubMedGoogle Scholar
  4. 4.
    Brunner H, Northfield TC, Hofmann AF, Go VLW, Summerskill WHJ (1974) Gastric emptying and secretion of bile acids, cholesterol, and pancreatic enzymes during digestion. Duodenal perfusion studies in healthy subjects. Mayo Clin Proc 49:851–860PubMedGoogle Scholar
  5. 5.
    Caspary WF (1983) Resorption von Oxalsäure und intestinale Hyperoxalurie. In: Caspary WF (Hrsg) Handbuch der Inneren Medizin, Band 3/3A, Dünndarm. Springer, Berlin Heidelberg New York, S 298–308Google Scholar
  6. 6.
    Caspary WF (1984) Stärkeblocker als Schlankmacher? Med Klinik 79:236–238Google Scholar
  7. 7.
    Caspary WF (1986) Diarrhoea associated with carbohydrate malabsorption. Clin Gastroenterol 15:631–655PubMedGoogle Scholar
  8. 8.
    Caspary WF (1987) Pathophysiologie von Malassimilationssyndromen. In: Caspary WF (Hrsg) Struktur und Funktion des Dünndarms. Excerpta Medica, Amsterdam, S 143–163Google Scholar
  9. 9.
    Chung JB, Tohno H, Sarr MG, DiMagno EP (1990) Gastric emptying (GE) of carbohydrate (CHO), fat (F) and protein (P) and secretion of each nutrient’s specific hydrolytic enzyme in dogs. Pancreas 5:702Google Scholar
  10. 10.
    DiMagno EP (1974) Medical treatment of pancreatic insufficiency. Mayo Clin Proc 54:435–442Google Scholar
  11. 11.
    DiMagno EP (1991) Future aspects of enzyme replacement therapy. In: Lankisch PG (ed) Pancreatic enzymes in health and disease. Springer, Berlin Heidelberg New York Tokyo, pp 209–214Google Scholar
  12. 12.
    DiMagno EP (1991) Patterns of human exocrine pancreatic secretion and fate of human pancreatic enzymes during aboral transit. In: Lankisch PG (ed) Pancreatic enzymes in health and disease. Springer, Berlin Heidelberg New York Tokyo, pp 1–10Google Scholar
  13. 13.
    DiMagno EP, Go VLW, Summerskill WH (1973) Relations between pancreatic enzyme outputs and malabsorption in severe pancreatic insufficiency. New Engl J Med 288:813–815PubMedCrossRefGoogle Scholar
  14. 14.
    DiMagno EP, Malagelada J-R, Go VLW, Moertel CG (1977) Fate of orally ingested enzymes in pancreatic insufficiency:comparison of two dosage schedules. N Engl J Med 296:1318–1322PubMedCrossRefGoogle Scholar
  15. 15.
    DiMagno EP, Hendricks JC, Go VLW, Dozois RR (1979) Relations among canine fasting pancreatic and biliary secretions, pancreatic duct pressure and duodenal phase III motor activity — Boldyreff revised. Dig Dis Sci 24:689–693PubMedCrossRefGoogle Scholar
  16. 16.
    Elsenhans B, Caspary WF (1983) Resorption von Eiweiß. In: Caspary WF (Hrsg) Handbuch der Inneren Medizin, Band 3/3A, Dünndarm. Springer, Berlin Heidelberg New York, S 157–170Google Scholar
  17. 17.
    Fölsch UR (1984) Pankreasenzym-Präparate zur Schmerztherapie bei chronischer Pankreatitis. Dtsch Ärztebl 86:792–793Google Scholar
  18. 18.
    Gangl A (1983) Resorption von Triglyceriden und fettlöslichen Vitaminen (außer Vitamin D). In: Caspary WF (Hrsg) Handbuch der Inneren Medizin, Band 3/3A, Dünndarm. Springer, Berlin Heidelberg New York, S 179–215Google Scholar
  19. 19.
    Graham DY (1982) Pancreatic enzyme replacement. The effect of antacids or cimetidine. Dig Dis Sci 27:485–490PubMedCrossRefGoogle Scholar
  20. 20.
    Holgate AM, Read NW (1985) Effect of ileal infusion of intralipid on gastrointestinal transit, ileal flow rate, and carbohydrate absorption in humans after ingestion of a liquid meal. Gastroenterology 88:1005–1011PubMedGoogle Scholar
  21. 21.
    Ihse I (1991) Treatment of pain in chronic pancreatitis with pancreatic enzymes. In: Lankisch PG (ed) Pancreatic enzymes in health and disease. Springer, Berlin Heidelberg New York Tokyo, pp 89–94Google Scholar
  22. 22.
    Ihse I (Hrsg) (1990) Pancreatic pain-causes, diagnosis, and treatment. Acta Chir Scand 156:257–321Google Scholar
  23. 23.
    Ihse I, Lilja P, Lundqvist I (1977) Feedback regulation of pancreatic enzyme secretion by intestinal trypsin in man. Digestion 15:303–308PubMedCrossRefGoogle Scholar
  24. 24.
    Isacksson G, Ihse I (1983) Pain reduction by an oral pancreatic enzyme preparation in chronic pancreatitis. Dig Dis Sci 28:97–102CrossRefGoogle Scholar
  25. 25.
    Kerlin P, Wong L, Harris B, Capra S (1984) Rice flour, breath hydrogen and malabsorption. Gastroenterology 87:578–585PubMedGoogle Scholar
  26. 26.
    Lankisch PG, Lembcke B, Wemken G, Creutzfeldt W (1986) Functional reserve capacity of the exocrine pancreas. Digestion 35:175–181PubMedCrossRefGoogle Scholar
  27. 27.
    Lankisch PG (1991) Differential treatment of exocrine pancreatic insufficiency in chronic pancreatitis. In: Lankisch PG (ed) Pancreatic enzymes in health and disease. Springer, Berlin Heidelberg New York Tokyo, pp 191–208Google Scholar
  28. 28.
    Layer P, Go VLW, DiMagno EP (1986) Fate of pancreatic enzymes during small intestinal aboral transit in humans. Am J Physiol 251:G475–480PubMedGoogle Scholar
  29. 29.
    Lembcke B, Stein J (1991) Vitamin deficiency in chronic pancreatitis:assessment and treatment. In: Lankisch PG (ed) Pancreatic enzymes in health and disease. Springer, Berlin Heidelberg New York Tokyo, pp 155–165Google Scholar
  30. 30.
    Liddle RA (1991) Congenital and heriditary diseases of the pancreas. In: Yamada T (ed) Textbook of Gastroenterology. Lippincott, Philadelphia, pp 1937–1451Google Scholar
  31. 31.
    Liener JE, Goodale RL, Doshmukh A, Sattaberg THL, Ward G, Diletro CM, Bankey PE, Borner JW (1988) Effect of a trypsin inhibitor from soya-beans ( Bowman-Birk) on the secretory activity of the human pancreas. Gastroenterology 94:419–427PubMedGoogle Scholar
  32. 32.
    Littlewood JM (1991) Pancreatic enzymes in cystic fibrosis. In: Lankisch PG (ed) Pancreatic enzymes in health and disease. Springer, Berlin Heidelberg New York Tokyo, pp 178–189Google Scholar
  33. 33.
    Meyer JH (1991) Delivery of pancreatin in microsphere preparations:transit, timing, physiological needs. In: Lankisch PG (ed) Pancreatic enzymes in health and disease. Springer, Berlin Heidelberg New York Tokyo, pp 71–88Google Scholar
  34. 34.
    Mössner J, Secknus R, Meyer J, Niederau C, Adler G (1991) Schmerzbehandlung der chronischen Pankreatitis mit Pankreasenzymen: Ergebnisse einer Multizenter Studie. Z Gastroenterol 29:483 (abstract)Google Scholar
  35. 35.
    Owyang C, Louie D, Tatum D (1988) Feedback regulation of pancreatic enzyme secretion. J Clin Invest 77:2042–2047CrossRefGoogle Scholar
  36. 36.
    Ramo DJ, Puolakkainen PA, Seppalo K et al (1991) Selfadministration of enzyme substitution in the treatment of exocrine pancreatic insufficiency. Scand J Gastroenterol 24:688–692CrossRefGoogle Scholar
  37. 37.
    Reagan PT, Malagelada J-R, DiMagno EP, Go VLW (1977) Comparative effects of antacids, cimetidine and enteric coating on the therapeutic response to oral enzymes in severe pancreatic insufficiency. New Engl J Med 297:854–858CrossRefGoogle Scholar
  38. 38.
    Reagan PT, Malagelada J-R, DiMagno EP, Go VLW (1979) Reduced intraluminal bile acid concentration and fat maldigestion in pancreatic insufficiency:correction by treatment. Gastroenterology 77:285–289Google Scholar
  39. 39.
    Roy CC, Weber AM, Lapage G, Smith L, Levy E (1988) Digestive and absorptive phase anomalies associated with the exocrine pancreatic insufficiency of cystic fibrosis. J Pediatr Gastroenterol Nutr 7 [Suppl]:S 1-S 7CrossRefGoogle Scholar
  40. 40.
    Slaff J, Jacobson D, Tillamn CR, Curington C, Toskes P (1984) Protease-specific suppression of exocrine pancreatic secretion. Gastroenterology 87:41–52Google Scholar
  41. 41.
    Stein J, Bieniek U, Lembcke B (1991) Infrarotspektroskopische Stuhlfettbestimmung:Vergleich mit der van de Kamer-Methode. Z Gastroenterologie 29:506 (abstract)Google Scholar
  42. 42.
    Stafford RJ, Grand RJ (1982) Hereditary disease of the exocrine pancreas. Clin Gastroenterol 11:141–170PubMedGoogle Scholar
  43. 43.
    Thiruvengadam R, DiMagno EP (1988) Inactivation of human lipase by proteases. Am J Physiol 255:G476–481PubMedGoogle Scholar
  44. 44.
    Toskes PP (1980) Current concepts of cobalamin (vitamin B12) absorption and malabsorption. J Clin Gastroenterol 2:287–297PubMedCrossRefGoogle Scholar
  45. 45.
    Vantrappen GR, Peeters TL, Janssens J (1979) The secretory component of the interdigestive migrating motor complex in man. Scand J Gastroenterol 14:663–667PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • W. F. Caspary

There are no affiliations available

Personalised recommendations