Pancreatic enzymes: function, deficiency and supplements
The pancreas is a vital gland in the body that secretes digestive enzymes, also known as pancreatic enzymes. Lipase, amylase and protease digest lipids, starch and proteins respectively.
Moreover, these enzymes help in the transportation and absorption of food. There are several medical conditions that can cause malfunction of the pancreas. During such conditions, it is advisable to take pancreatic enzyme replacement therapy.
In this article, we shall discuss all the function of pancreatic enzymes, their deficiency, and pancreatic enzyme supplement.
What does it mean by pancreatic enzymes?
Pancreatic enzymes are a kind of protein that your pancreas secretes. These enzymes can help you digest the ingested food such as fats, proteins, and carbohydrates.
A normal healthy pancreas can secrete more than 7 cups of pancreatic enzymes in a day. The Pancreas secretes the enzymes and passes it on to the duodenum, where the enzyme is temporarily stored.
Duodenum then delivers the secreted enzymes and bicarbonates into the small intestine.
Enzymes help in digestion, whereas, the bicarbonates help in neutralizing the acidic pH of the small intestine.
Types of Pancreatic Enzymes and Their Function
Lipases are enzymes produced by the pancreas that digest your ingested lipid such as fats, oils and triglycerides. Lipase breaks the triglyceride into monoglyceride and fatty acids.
Moreover, these enzymes can help in transporting and absorbing the ingested lipids.
There are two kinds of lipase secreted by pancreas they are:
- Pancreatic lipase (PL)
- Pancreatic lipase-related protein 2 (PLRP2).
The lipase enzymes level should be in the normal range. Fluctuations from normal range can cause serious medical conditions.
Normal lipase level: 0-160 U/L depending on the lab.
Low lipase level: If your pancreas does not secrete enough lipase, the cells that produce these enzymes are either damaged or not working properly.
Low level of lipase level can be an indication of cystic fibrosis.
Reduced lipase secretion from pancreas can cause indigestion of fats and fatty stool.
Amylase is an enzyme produced at two places, initially secreted by salivary glands and again secreted by the pancreas.
Human being produces alpha-amylase. Alpha-amylase breaks down the starch into maltose (consist of two molecules of glucose).
The amylase produced in the mouth digest starch during the initial stage.
Once the food reaches the small intestine, the pancreas secretes the pancreatic lipase into the small intestine through a duct.
In the small intestine the pancreatic enzyme digest the rest of the starch, break it into simple sugar molecules. Then, in the form of glucose, the body absorbs carbohydrates and distribute to the cell through blood circulation.
Higher amylase level is seen in various medical conditions such as:
- Infection of the pancreas
- Pancreatic cancer
In case of pancreatitis, the level of amylase is more than three times of the normal upper limit.
Low level of the pancreas can be seen in acute pancreatitis. In such condition, the pancreatic cells are damaged and usually secrete less amylase.
The condition of less secretion is also known as exocrine pancreatic insufficiency (EPI).
Shwachman-Diamond syndrome and cystic fibrosis are also known to cause exocrine pancreatic insufficiency.
Blood amylase level in a normal healthy person is 23-85 units per liter (U/L). Some lab results may show up to 140 U/L of amylase.
Protease is a vital pancreatic enzyme secreted by the pancreas. It digests the ingested protein.
These are the groups of enzymes that break the peptide bond of the amino acids and make simpler peptides. Therefore, these are also called proteolytic enzymes.
It protects our gut from parasites, protozoa, and other microorganisms. Deficiency of this enzyme may cause accumulation of toxins in the body and gut infection.
Why there is a need of pancreatic enzyme supplement?
Sometimes, due to various medical conditions, the pancreas does not secrete enough enzymes. Various medical conditions causing pancreatic insufficiency include:
- Pancreatic ulcer
- Duodenal ulcer
- Pancreotomy (Removal of the pancreas by surgery or Whipple procedure)
- Narrow pancreatic duct
- Cystic fibrosis
- Prolonged intake a medication called Sandostatin
- Chronic pancreatitis
Such pancreatic insufficiency hinders the proper digestion of foods and absorption of nutrients.
If a person suffers from pancreatic cancer, he is very likely to have pancreatic insufficiency. Insufficient pancreatic enzymes cause poor digestion of food and require pancreatic enzyme supplement to meet the needs.
Pancreatic enzyme supplements promote proper digestion of ingested food and help in better absorption of nutrients.
Lack of pancreatic enzymes manifests many symptoms and they include:
- Flatulence (Formation of gas in the stomach)
- Abdominal cramps
- Body weight loss
- Foul smelling fatty stool.
- Bright yellow colored stool
- Frequent defecation
Guidelines to take pancreatic enzymes supplement pills
Pancreatic insufficiency or exocrine pancreatic insufficiency produces inadequate enzymes for digestion and absorption of food. Therefore, you need pancreatic enzyme pills as the pancreatic enzyme replacement therapy. But, random intake of the pills will not produce good results.
To get the best out of the pancreatic enzyme replacement therapy, you must follow the guidelines to consume these pills.
First of all consult your doctor, if you really require the replacement therapy. The physician will tell if it is going to be helpful for you to take it.
If the physician suggests you take these pills, ask him for directions to take it. Else, here are the few guidelines you should follow while taking the pancreatic enzyme replacement therapy.
Decide the dose and frequency:
Calculate the dose and frequency of your pill before taking. The dose and frequency vary from person to person. There are people who take 2 pills per day while others take more than 2 or less.
There are various factors to consider while deciding the dose and frequency of pancreatic enzyme replacement therapy. The factors include:
- Age and the sex of the patient
- The concentration of the pill
- Fat content and size of the meal
- The goal of taking the pills (Whether to take it to curb bloating or reduce diarrhea)
There are various brands of the enzyme. They come with different concentrations. So, it is advisable to consult the doctor to decide the dose and intake frequency of the pill.
There are many over the counter enzymes available in the medical store. However, not all the pills are approved by FDA (Food and Drug Administration).
FDA has approved only 6 pancreatic enzymes such as Ultresa, Creon, Pancreaze, Viokace, Zenpep, and Pertzye.
How to take the pancreatic enzymes supplement pill?
Always take the first pill at the beginning of your meal. If you take the enzyme pill before the meal, it will not work at the optimum level.
Whenever you consume the pill at the beginning of your meal, it will come in contact with the food and mix properly.
When the doctor has asked you to take the second pill too, try to consume it at the end if your meal. The second pill will work till the digestion of food and ensure proper absorption as well.
Don’t consume it in an empty stomach:
The purpose of this pill is to break down the ingested food and promotes better absorption. But, it can only be possible if the enzyme mixes well with the food.
According to the National Pancreas Foundation, food can mix well with the enzyme if you take the pill at the beginning of your meal. Consumption of the pill in an empty stomach does not produce the expected results.
Guidelines to take pancreatic enzymes supplement pills
Do not overdose: Once you consume the pill, it will work until one hour of the consumption.
The medication is well tolerated. Try not to take the pancreatic enzyme pill again and again. It is because; overdose of the enzyme pill can produce side effects.
Do not skip the dose: If you skip the pill at the beginning of the meal, do not take the pill in the next meal. You can skip the pill for the day and try to consume it at the right time the next day.
According to experts, skipping pills is not very harmful but overdose is. But, it is always advisable; do not skip the enzyme pill.
Don’t chew the capsule: Never ever chew the capsule. Chewing the capsule will release the enzymes in your mouth and stomach, the acids present in your stomach will destroy the pancreatic enzymes.
Moreover, people have experienced irritation of gums and mouth upon contact with the medication. Therefore, don’t consume a part of the capsule swallow it whole.
Drink water: It is advisable to drink water as much as you can. This will keep you hydrated. Besides this, drink some amount of water while taking the meal.
This will provide your stomach an environment for the bowel movement and the pill will pass on to the small intestine. In the small intestine, the pill will release the enzymes, where it will mix up with the food to do its job.
Consume reduced dose during snacks: You can consider taking the small or reduced dose during your snacks. It will work to digest and absorb the snacks as well. But, before that, always consult your physician about it. Take his suggestions and implement.
Store the medicine at a safe place: Always store the medicine at room temperature away from sun light. There is no need to refrigerate it as well.
Higher temp can degrade the medicine, so, the ideal temp is always the room temperature. Avoid moisture around the pancreatic enzyme pill. Moisture has the tendency to degrade the medication.
Take the right medication:
Most of the pancreatic enzyme pills are made up of the pancreas of pigs. So, if you are allergic to pig products, try to avoid the pills or consult your physician and ask for alternatives.
Some of the medication comes with a special kind of coating on it. These coatings do not let the medication to degrade in the stomach. It helps to release the enzyme in the small intestine.
If you are taking such pills there is no need of consuming proton pump inhibitors such as omeprazole or esomeprazole.
But, if you are taking the pill without the special coating, you need to consume the pill along with proton pump inhibitors.
Side effects of the pill:
There is always some side effect of any medication. But you are still taking it because the benefits you are getting are much higher than the side effects.
Let us discuss some of the common side effects of pancreatic enzymes replacement pill. The side effects are:
- Abdominal cramps
You are very less likely to experience very serious side effects from this medication. Very various side effects are rare and include:
- Allergic reaction
- Swelling of face, throat or tongue
- Pain during urination
- Painful joints
If you experience any of the above symptoms, immediately consult your doctor and take help.
Pancreatic enzymes play a crucial part to digest, transport and absorb the ingested fat diet. But lack of this enzyme diminishes all these functions. Pancreatic enzyme replacement therapy can manage intrinsic deficiency.
There was an earlier concept, that you should consume a less fat diet in order to avoid the side effects of the deficiency of these enzymes. But, now the trend has changed.
Studies shows, there is no harm in consumption of balanced fat diet, i.e. 30 percent of your calories should consist of fat. However, this can only work if you are on pancreatic enzyme replacement therapy.
Make some dietary changes for good health and to meet the need of good fat in your diet. Add polyunsaturated fatty acids and omega-3 fatty acids in your fat diet.
Be, aware with the guideline to take the pill, its side effects and precautions. Always consult your doctor for any inconvenience and follow his suggestions.