There are several different formulations containing pancreatic enzymes (lipase, amylase, protease) for replacement in patients with malabsorption related to pancreatic exocrine deficiency.
Indications: Partial or complete pancreatic exocrine deficiency, resulting in
(1) significant fat malabsorption with steatorrhea
(2) malnutrition. In children this may be associated with failure to thrive.
Conditions in which pancreatic enzyme replacement therapy may be considered:
(1) cystic fibrosis
(2) chronic pancreatitis
(3) subtotal or total pancreatectomy
(4) obstruction at the Ampulla of Vater or main pancreatic duct
(5) pancreatic exocrine insufficiency associated with trauma, hemochromatosis, hyperparathyroidism, Shwachman's syndrome, or other pancreatic disorder
(6) gastric bypass surgery or resection with poor mixing
Contraindications:
(1) hypersensitivity to porcine proteins (all of the formulations I reviewed were prepared from pork pancreas).
(2) during episodes of acute pancreatitis or acute exacerbations of chronic pancreatic disease
