Abstract
To the Editor: Oral pancreatic extracts are useful in the treatment of malabsorption due to pancreatic insufficiency, but the steatorrhea is not always completely abolished.1 In vitro and in vivo observations suggest that this therapeutic failure is due to peptic inactivation of lipase2 , 3 and acidic precipitation of bile acids.4 Regan et al., have compared the effects of antacids, cimetidine (a potent inhibitor of gastric acid secretion), and enteric coating on the therapeutic response to oral enzymes in six patients with severe pancreatic insufficiency.5 They concluded that the combination of cimetidine with pancreatic extracts was superior to other treatments in alleviating . . .