The Ins and Outs of Oral Pancreatic Enzymes

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Abstract
Treating pancreatic exocrine insufficiency with orally administered pancreatic enzymes is more difficult than is usually imagined.1 The goals of therapy are to prevent weight loss and muscle wasting, to reduce or eliminate diarrhea and (in children) to establish adequate nutrition for growth. Usually, these objectives are achieved, but only in a minority of patients can assimilation of dietary fat be restored to normal with the aid of pancreatin.2 As pointed out in two articles (by DiMagno et al. and Graham) in this issue of the Journal, the problem is one of getting enough active enzyme to the duodenum at . . .