Effect of enteric coated sodium bicarbonate, enzymes and bile combination on the absorption of fat in chronic pancreatitis

Abstract

The effects of (A) H2-receptor antagonist (ranitidine) and
enzyme preparation with bile constituents (Digestal forte),
(B) Digestal forte and NaHCO3, (C) NaHCO3 alone, or (D)
Digestal forte alone, on the increase of lipolysis, were studied
in a double-blind, randomized, prospective, controlled
cross-over study in 10 patients with chronic pancreatitis
(CP) and steatorrhea. All preparations were enteric-coated
tablets except ranitidine.
The 14C triolein breath test was used to monitor the lipolytic
effect of the regimens, the parameter for the efficacy
assessment being cumulative recover (CR) of 14CO2 after 6
hours. Before the treatment patients underwent the same
test procedure.
The regimen B produced significantly higher increase in
CR, as compared to other regimens (p<0.01). A, B and D
regimens induced a significant increase in CR compared
to baseline CR (p<0.01), while regimen C had no effect
(p>0.05). No differences were observed between the regimes
A and D (p>0.05).
The results showed that exogenous lipolytic action of Digestal
forte remained unaffected by ranitidine (p>0.05).
This study suggests that the adding of bicarbonate with
Digestal forte may play an important role in the regulation
of lypolysis in these patients.
Key words: Chronic pancreatitis, enzyme substitution, bicarbonate,
ranitidine