Enzymes (synonym: enzymes) of the digestive system are protein catalystswhich are produced by the digestive glands andbreak down food nutrients into simpler components during digestion.

Enzymes (Latin), they are also enzymes (Greek), are divided into 6 main classes.

Enzymes that work in the body can also be divided into several groups:

1. metabolic enzymes - catalyze almost everything bio chemical reactions in the body for cellular level. Their set is specific for each cell type. The two most important metabolic enzymes are: 1) superoxide dismutase (SOD), 2) catalase. WITHsuperoxide dismutase protects cells from oxidation.Catalase decomposes hydrogen peroxide, which is dangerous for the body, which is formed in the process of metabolism, into oxygen and water.

2. Digestive enzymes - catalyze the breakdown of complex nutrients(proteins, fats, carbohydrates, nucleic acids) into simpler components. These enzymes are produced and act in digestive system organism.

3. Food Enzymes - enter the body with food. Curiously, some food products include a fermentation step during their manufacturing process, during which they are saturated with active enzymes. Microbiological processing food products also enriches them with enzymes of microbial origin. Of course, the presence of ready-made additional enzymes facilitates the digestion of such products in the gastrointestinal tract.

4. Pharmacological enzymes - are introduced into the body in the form of medicinal preparations in medicinal or preventive purposes. Digestive enzymes are one of the most commonly used groups of drugs in gastroenterology. The main indication for the use of enzymatic agents is the state of impaired digestion and absorption. nutrients- maldigestion / malabsorption syndrome. This syndrome has a complex pathogenesis and can develop under the influence of various processes at the level of secretion of individual digestive glands, intraluminal digestion in the gastrointestinal tract (GIT) or absorption. Most common causes disorders of digestion and absorption of food in the practice of a gastroenterologist are chronic gastritis with reduced acid-forming function of the stomach, post-gastroresection disorders, cholelithiasis and biliary dyskinesia, exocrine pancreatic insufficiency. Currently, the global pharmaceutical industry produces a large number of enzyme preparations, which differ from each other as the dose contained in them digestive enzymes and various additives. Enzyme preparations are available in different form- in the form of tablets, powder or capsules. All enzyme preparations can be divided into three large groups: tablet preparations containing pancreatin or digestive enzymes plant origin; drugs, which include, in addition to pancreatin, bile components, and drugs produced in the form of capsules containing microgranules with an enteric coating. Sometimes the enzyme preparations include adsorbents (simethicone or dimethicone), which reduce the severity of flatulence.

Groups of digestive enzymes

• Proteolytic (proteases, peptidases) - break down proteins into short peptides or amino acids.
  
• Lipolytic (lipases) - break down fats to glycerol and fatty acids.
  
• Amylolytic (amylase, carbohydrase) - break down polysaccharides (starch) to simpler sugars (disaccharides or monosaccharides).
  
• Nucleases - break down nucleic acids into nucleotides.

Table of enzymes of the gastrointestinal tract (gastrointestinal tract)

Preparations containing digestive enzymes are currently widely used in the treatment of diseases. gastrointestinal tract. The main direction in the treatment of enzymes - replacement therapy with insufficiency of their own enzymes. There are two directions of action of enzyme preparations: 1. splitting food with exocrine pancreatic insufficiency, 2. reducing abdominal pain in diseases of the stomach and intestines, dyspepsia (feeling of heaviness, bloating, belching, stool disorders).
Indications for the appointment of enzymes: violation of the production and secretion of enzymes by the pancreas, violation of intestinal absorption, violation of the motor activity of the gastrointestinal tract.

Classification of enzyme preparations.

1. Preparations containing pancreatin(penzital, pancreatin, mezim forte, pancitrate, creon, pancreoflat, pangrol, pancreon). Indications for the appointment of enzyme preparations containing pancreatin are various states, accompanied by a violation of the exocrine function of the pancreas, dysbacteriosis, in which their own enzymes are destroyed by microorganisms that seed the small and duodenal intestines, with peptic ulcer with high content hydrochloric acid and pepsin in gastric secretion, in acute infectious and chronic diseases intestines, accompanied by syndromes of maldigestion and malabsorption (difficult parietal intestinal digestion and absorption), congenital deficiency enzymes.

2. Preparations containing pancreatin, bile components, hemicellulase and other components(festal, digestal, panzinorm, enzistal, ipental, kadistal, kotazim forte, menzim, pankurmen, pankral). Bile acids, which are part of the preparations, increase the secretion of the pancreas, motor activity intestines and gallbladder. Hemicellulase increases the breakdown of complex sugars of plant origin, reduces gas formation. Combined drugs are prescribed with a predominance of constipation, flatulence, belching, accompanying acute and chronic pathologies intestines, dysbacteriosis.
Contraindications for the appointment of combined drugs with bile components are pancreatitis (acute and chronic), hepatitis, diarrhea, peptic ulcer stomach and duodenum, inflammatory diseases intestines.

3. Herbal preparations containing rice fungus extract, papain and other components(pepfiz, orase, nigedase, solizim, somilase, unienzyme). They are used for insufficiency of the exocrine function of the pancreas and for intolerance to beef or pork.
Solizyme and somilase are contraindicated in case of allergy to antibiotics. penicillin series.

4. Combined preparations in which pancreatin is combined with plant enzymes, vitamins(wobenzym, phlogenzym, merkenzym). Herbal preparations are contraindicated in bronchial asthma, allergies to fungi and household dust.
Herbal preparations are 75 times less effective than preparations based on animal enzymes.

5. Simple Enzymes(abomin, betaine) have proteolytic activity and do not belong to pancreatic enzymes. Currently used less.
Abomin is a preparation from the gastric mucosa of calves and lambs, acidin-pepsin based on pepsin and betaine, pepsidil contains pepsin and peptones, pepsin is obtained from the mucous membrane of pigs and lambs. The presence of pepsin, cathepsin, peptidases, amino acids in these preparations promotes the release of gastrin, which increases gastric secretion and motor activity of the gastrointestinal tract. Preparations of this group are prescribed for gastritis with secretory insufficiency.

Enzyme preparations can be used both once (with a significant food or alcohol load), and with long-term treatment. The effectiveness of the drug is indicated by the normalization of the patient's condition (disappearance of pain, normalization of the frequency and nature of the stool) and laboratory changes (normalization of elastase in the feces).
Doses of enzymes are selected individually in terms of lipase activity.
The reasons for the lack or decrease in the effect of treatment with enzymes may be inadequate doses of the drug, inactivation of the enzyme in the stomach, destruction of enzymes during intestinal dysbacteriosis
It is possible to reduce the inactivation of enzymes by gastric juice by simultaneously prescribing H2 blockers. histamine receptors or antacids.

Self-administration of enzyme preparations is possible once during food overload, since for long-term therapy correct calculation and selection of dosages, as well as adequate monitoring of clinical and laboratory changes. In addition, long uncontrolled reception enzyme preparations, especially high dosages able to suppress the activity of its own secretion glands.

Food is a source of energy for life, development, growth. It turns into a beneficial extract during digestion. Teeth, jaws, muscles of the esophagus, stomach, intestines provide machining. There is grinding, moving, mixing. Enzymes of the stomach, pancreas, alkali, acid, mucin and more provide chemical processing.

Once in the body, food is broken down by enzymes and gastric juice. Enzymes are catalysts for chemical reactions. Salivary glands produce many of them. Together with food, with the help of swallowing movements, the body transports them to other departments. Digestion continues in the intestines, but the main work takes place, nevertheless, in the human stomach.

Through the walls of the stomach and intestines useful material enter the blood, are transported to all organs and tissues. The role of digestive enzymes is difficult to overestimate. They are present in the body in a strictly defined amount. Even a slight disturbance in the process of their production can lead to serious disorders digestion, gradual depletion of the body.

With a long-term, stable violation of their balance, a normal, full-fledged, healthy, natural nutrition every cell is in question. After some time, complications appear, and only medications designed for this. Controlling the balance, eating right is an art that anyone can master.

natural balance

Man is accustomed to experiments in food. Culinary tradition - information accumulated over many centuries about useful and junk food, environment, ways to survive in bad weather, changing seasons, low yields. People are accustomed to eating three times a day, eating hot and cold, carefully grinding some foods, and chewing others, getting decoctions, creating a bouquet of taste. Culinary traditions influence natural processes. How much is the question.

Biological digestion catalysts are produced not only taking into account the characteristics of the environment, but also taking into account genetic program kind. A person should not have big problems with digestion - this is how nature intended. Is it really?

More on the topic: How does the human stomach work? Consider options for working at night while sleeping

Digestion may require attention at any time. The daily diet is to blame or not, and some features of the food culture that are loved, however biological value don't have, it's important to know. This will help rationalize nutrition, restore balance.

Biologically unsound

Delicious recipes are not dangerous to health - that's for sure. Variety on the menu gives good mood, mass positive emotions. Going to a cafe, coming to visit, improving your own skills, you can try everything and even need to. Life will be more fun. Nevertheless, there is something to think about, what to change.

Under certain circumstances, digestive enzymes lose some of their activity, although it is needed. This happens when the food is very hot or very cold. At the same time, more time is spent on digestion, useful substances may not be completely absorbed. The optimum temperature is 38 -45 degrees. Biological digestion catalysts are partly composed of proteins.

If the temperature is above or below these values, their structure will collapse. As a result, the body will have to develop new and new batches, while the feeling of hunger will not disappear. If you eat foods with normal temperature, enzymes for digestion will be synthesized in correct proportions. It depends on the temperature of the products which portion is enough to saturate, how much benefit the body will take.

The brain determines which catalysts need to be produced. If the food is familiar, will automatically be synthesized certain types. This simplifies the digestion process and helps the body conserve energy, but when confronted with new, unknown products, sometimes difficulties arise - they need to be tasted, they may not be liked right away.

To process them, the body needs a lot of energy, the brain does not know how to respond to them. There are those catalysts that are always synthesized. They are called the main ones and for good reason. Due to their presence, the survival of the species is possible even with a sharp change in diet. The benefits of food will be taken.

Enzymes of this department

In the stomach, under the influence of smell, appearance, taste, signals that the brain sends are synthesized:

• pepsin;
• lipase;
• amylase.

More on the topic: What should be taken when there are cramps in the stomach after eating?

They are produced by glands located in the mucous membrane of the walls. They are small in size and there are many of them. The inner surface is not at all smooth - it is all covered with tubercles and pits. The glands of the stomach form such a relief. Channels for transporting substances look like pits. Mucus layer protects inner surface from destruction. You can’t do without this: the juice produced by the mucous membrane is hydrochloric acid. And this is not the only threat.

V this department The digestive system processes mainly protein. It is also found in the cells of the walls of the stomach. Therefore, for splitting, the body cannot synthesize any catalysts. We need special ones. The gastric proteolytic enzyme or protease is an ideal tool for protein processing. Substances belonging to this group act so that the protein that is part of the cells of the mucous membrane is not affected.

Amazing acid resistance

If hydrochloric acid enters the esophagus along with belching or into the intestines with the remains of undigested products, the so-called chyme, burns of the mucous membrane of these areas are possible, but the walls of the stomach can effectively resist it. Food is digested from 2 to 7 hours - depending on its characteristics. Hydrochloric acid is produced sometimes long before breakfast, lunch or dinner. All this time, the walls withstand the load.

Emergency transportation of food to other departments is not life-threatening, on the contrary, the mechanism exists to save health, it is activated in case of poisoning or their threat. The valve system protects the body from unnecessary damage. They can also suffer as a result of emergency transportation, in contact with gastric juice. With some functional, psycho-emotional disorders, burns become the norm, which can lead to severe deformation of the mucous membranes. Chyme and enzymes in the stomach should remain for some time.

They can be excreted only when the acid is neutralized: absorbed by the mucous membrane of the walls, enters the bloodstream. This is exactly what the human body does with its excess.

There can be many reasons for belching, early entry of chyme into the intestines, only after a thorough diagnosis, analysis of other symptoms, the picture as a whole, individual features, you can put correct diagnosis. Regardless of the cause, you should try to reduce the manifestation of symptoms - regular exposure to acid, tissue deformation may require surgical intervention as a result.

Many diseases modern humans are caused by enzyme deficiency. Previously, this problem was associated with age-related changes, but now more and more often the lack of enzymes in the body occurs in young people. What they are, how they affect health and how to make up for the deficiency of these important substances? Let's figure it out.

What are digestive enzymes for?

Everything is vital important processes provided by thousands of chemical reactions. They flow through the body mild conditions, no impact high pressure and temperature. Substances that are oxidized in human cells burn quickly and efficiently, providing the body with building materials and energy.

Rapid digestion of food in the cells of the body occurs under the influence of enzymes, or enzymes. These are biological catalysts, which, according to their functions, are divided into 3 large groups:

1. Amylase. This is the collective name for a group of enzymes that process. Each type of carbohydrate has its own type of amylase. Such enzymes are secreted along with gastric juice and saliva.
2. Lipase is a group of digestive enzymes that break down food into fats. They are secreted in the stomach and pancreas.
3. Protease is a group of enzymes that digest proteins. These digestive enzymes are synthesized with gastric and pancreatic juice, like lipase.

Swallowed food enters the stomach. There it is broken down by gastric juice, which contains hydrochloric acid and a number of digestive enzymes, including lipase, pepsin, and renin. Due to the lack of enzymes, a large amount of food is often not completely digested. In this form, food enters the alkaline environment of the duodenum 12. Here, pancreatic enzymes trypsin, elastase, amylase, lipase, carboxypeptidase and chymotrypsin, as well as bile, act on food.

Most foodstuffs after processing with the participation of digestive enzymes are absorbed in the small intestine. A smaller part goes to colon. Water is absorbed there, so the semi-liquid contents of the intestine gradually thicken. In this process again important role is given to enzymes, as well as dietary fiber.

During digestion, carbohydrates are broken down into monosaccharides (mainly glucose), proteins into amino acids, and fats into fatty acids. The products of transformation are then absorbed through intestinal walls into the blood and delivered to the tissues of the body, where they participate in intracellular metabolism.

Video: Enzymes in bodybuilding, pharmacy doping

Why is an enzyme deficiency formed and why is it dangerous?

Modern man does not get enough enzymes from food. The reason lies in heat treatment, since living enzymes are finally destroyed already at a temperature of +118 degrees. Do not contain enzymes and semi-finished products. Sterilization, pasteurization, multiple freeze-thaw cycles, cooking in microwave oven- all these processes inactivate digestive enzymes and disrupt their structure.

Foods devoid of live enzymes put a lot of stress on the body. To digest such food, he has to activate the production of additional enzymes, and at this time the synthesis of other important substances is inhibited.

Violation of digestion is fraught with the occurrence of diseases of the gastrointestinal tract, pancreas, liver, gallbladder. Signs of a digestive enzyme deficiency include:

• heartburn;
• flatulence;
• belching;
• headache;
• diarrhea;
• constipation;
• stomach colic;
• gastrointestinal infections.

These symptoms are experienced by a huge number of people, taking them for a common ailment. In fact, such signs signal that the body is not able to actively process food. The digestive organs work for wear and tear, their normal work. On this ground, diseases develop endocrine system, musculoskeletal system, reduced immunity.

The problem of obesity, which in the 21st century is becoming an epidemic, is associated with the peculiarities modern nutrition. people are eating now complex dishes high in fat and sugar. There are practically no fibers and digestive enzymes in them.

Foods that contain excess fats and "fast" carbohydrates are harmful. She leads to various diseases, reduces life expectancy. Scientists have found that after heat treatment, no enzymes remain in fats. At the same time, the body needs fats, as it is a powerful source of energy. Even without them, it is impossible to fully assimilate fat-soluble vitamins.

US scientists examined a group of people weighing in the region of 105-110 kg. All had a lack of lipases - enzymes that ensure the breakdown of fats. With a deficiency of these enzymes, fats are simply deposited on the hips, waist, liver, and other organs and parts of the body.

The situation is similar with carbohydrates. Carbohydrates found in fruits and other natural products, which are not subjected to heat treatment, retain enzymes, B vitamins, chromium. The problem is that now people eat a lot of refined sugar, and it has no digestive enzymes, no B vitamins, no chromium. To process this product, the body is forced to synthesize a large number of additional enzymes.

Due to a deficiency of proteases, the development allergic reactions and candidiasis. It's about about digestive enzymes that break down and remove foreign substances of a protein nature from the body. Among them are viruses, fungi, bacteria.

Enzyme Sources

As long as the body has enzyme activity factors, it produces new enzymes. Their "additional" source is food. Food containing live enzymes greatly facilitates digestion. Thermally processed food, which is devoid of enzymes and forces the body to produce them on its own, reduces the already limited enzyme potential. It is given to a person at birth and is designed for a lifetime.

Food

Rich sources of "additional" enzymes are dairy products, especially natural yoghurts and kefir. Contains many digestive enzymes sauerkraut, kvass own fermentation and Apple vinegar, exotic miso. They are rich in fruits and vegetables, but only in raw form, since heat treatment destroys enzymes. Particularly rich in these substances are garlic, horseradish, avocado, mango, papaya, grain and seed shoots, and soy sauce.

Enzymatic preparations

To compensate for the deficiency of digestive enzymes, medicines can be used:

1. Pancreatin-containing. These include Mezim, Creon, Pancreatin. Such drugs are optimal for maintaining the functions of the pancreas.
2. Medications with bile acids and others auxiliary components- Festal, Panzinorm. They stimulate the intestines and pancreas.
3. Preparations for the normalization of the work of the endocrine glands and the establishment of their own synthesis of enzymes - Oraza, Somilase.

Usually take 1-2 tablets during or after a meal. Like other medicines, enzyme preparations have contraindications and side effects. Therefore, it is safer to fill the deficiency of enzymes with the help of products, although they are less effective.

Before taking enzyme preparations, it is recommended to consult a doctor. Diagnostics is needed to identify which enzymes in the body are not enough. Digestive enzymes provide a short-term effect, and to restore metabolism, it is important to eliminate the root cause - cure the disease, adjust the diet or change your lifestyle.

What enzymes do dieters need?

When dieting for weight loss, the production of digestive enzymes is reduced. The content of enzymes in gastric and pancreatic juices and saliva becomes scarce, so a person needs to make up for their deficiency.

You can use digestive enzymes of animal and vegetable origin. Animal enzymes can be addictive, so it is preferable to take plant-based ones. Among them are bromelain, which is extracted from pineapples, and papain, contained in papaya fruits. These digestive enzymes remain active at temperatures much higher than inside the human body.

Fresh fruits and vegetables contain enzymes, but insufficient quantities. Initially, they contain enzymes responsible for maturation. As fruits and vegetables ripen, some of the enzymes return to the seeds and stems. Therefore, only the juice of an unripe fruit is taken to isolate papain. In ripe papaya, there is a slight content of enzymes.

One of the common reasons for recruiting excess weight in our time - insufficient production of pepsin in the digestive tract. In this case, it is useful to take bromelain. It is a powerful biological catalyst for carbohydrate and protein metabolism. It indirectly contributes to the accelerated breakdown of fats and their removal from the body. This plant enzyme also prevents the formation of subcutaneous fat deposits. On average, 1 g of high activity bromelain burns up to 900 g of fat.

Bromeilan works in different ways, it depends on the meal. When consumed with food, it serves as a digestive enzyme, helps break down and absorb proteins, activates other enzymes and generally normalizes digestion. Bromelain also improves the functional activity of the intestine, stimulating the excretion of metabolic products and toxins, maintaining the microflora of the large intestine. As a result, metabolism is normalized. When taking bromelain on an empty stomach, it has an anti-inflammatory effect, relieves pain and swelling, therefore it is used for joint diseases. It also reduces blood clotting.

Papain is a proteolytic enzyme that breaks down proteins. It is found in all parts of papaya except for the roots. This enzyme contains lysozyme, which destroys the toxins of various pathogens. infectious diseases including staphylococci and streptococci. Papain also prevents the formation of blood clots in the vessels, accelerates wound healing and trophic ulcers, bedsores. It stimulates their cleansing from necrotic masses. For those who lose weight, it is important that papain is often included in preparations for weight normalization. It improves digestion and breaks down proteins to a state in which they are quickly and easily absorbed.

For the normal digestion of food, biological catalysts are needed - enzymes. These are complex protein molecules, in the presence of which all chemical reactions proceed tens and hundreds of times faster! Without them, the digestion process would take years.

Each enzyme has its own specification: amylase breaks down carbohydrates into monomers, lipase - fats, proteases - proteins. There is certain types enzymes for nucleic acids (nucleases) and some other substances. But they all follow certain rules:

• Each enzyme has an active site suitable for only one type of digestible product;
• Each enzyme is active at a specific pH;
• Each enzyme is secreted in an inactive form, otherwise it will digest its own tissues;
• All enzymes, having performed their functions, are absorbed back into the blood or are destroyed to amino acids, thus their circulation occurs.

The process of enzymatic digestion of food begins at oral cavity, here amylase breaks down starch. Gastric juice contains pepsin - an enzyme that breaks down protein into smaller fragments - peptides.

The pancreatic duct (PJ) enters the duodenum, and it is she who synthesizes the main amount of the necessary digestive enzymes - amylase, protease and lipase. Moreover, lipase is predominantly of pancreatic origin, while amylase and proteases are secreted in sufficient quantities by cells. small intestine. That is why, in diseases of the pancreas, the digestion of fats is the first to suffer, a person is forced to sit on lean diet because the reception fatty foods causes nausea, epigastric pain and diarrhea (fatty frothy stools).

The spectrum of pancreatic enzymes is highly variable and adapts to the normal human diet. Vegetarians have almost no proteases in pancreatic juice, people who do not consume fats have lipases. That is why in violation of the diet, digestive disorders can occur.

Pancreatic enzymes are active in alkaline environment duodenum, where there is a lot of bile and bicarbonate. Bile also emulsifies fats, aiding in their digestion.

Exocrine pancreatic insufficiency occurs with pancreatitis, prolonged strict diet, tumors and general malnutrition, protein starvation. Often hepatitis and gastritis are accompanied by a violation of the secretion of enzymes. First of all, this condition is manifested by a lack of lipase, and only then - all other components of pancreatic juice. Vomiting, nausea, weakness, weight loss, signs of vitamin deficiency, decreased appetite, unstable stools are signs of pancreatic enzyme deficiency and, as a result, impaired digestion of essential nutrients.

Enzyme preparations

For over 100 years, the pharmaceutical industry has been producing pancreatic enzymes in the form of pancreatin - a powder from the pancreas of pigs. The activity of all drugs is standardized precisely with respect to pancreatin by lipase, and ranges from 15 to 45 units.

Classification of enzyme preparations

1. extracts of the gastric mucosa containing pepsin (abomin, acidinpepsin, pepsin, acidin). Applicable for atrophic gastritis with reduced acidity, contraindicated in exocrine pancreatic insufficiency.
2. pancreatic containing enzymes amylase, lipase and trypsin (pancreatin, pancitrate, mezim-forte, creon)
3. pancreatic enzymes with the addition of bile (digestal, festal), cellulose and other components (panzinorm-forte, enzistal). Hemicellulose in the composition of festal contributes to the normalization of stool and microflora, bile stimulates bile secretion, motility and secretion, and fights constipation. This group drugs are used for combined pathology of the liver and pancreas, constipation, physical inactivity, short-term errors in the diet. They cannot be used for a long time and with spastic type of biliary dyskinesia and IBS.

Preparations containing bile should not be used for:

• pancreatitis
• hepatitis
• ulcers of any localization
• inflammation of the gastrointestinal tract
• diarrhea

4. plant enzymes - papain, etc. (pepfiz, oraza)

The group of plant enzymes includes:

• nigedase - contains only vegetable lipase, is used together with pancreatin;
• orase - a complex of enzymes of fungal origin (lipase, amylase, maltase, protease from the fungus aspergillus);
• pepfiz - fungal diastase (amylase), papain and simethicone;
• solizim - lipase from a penicillin fungus;
• somilase - salt and fungal amylase;
• Unienzyme - fungal amylase, papain, simethicone, Activated carbon, nicotinamide;
• wobenzym - pancreatin, papain, bromelain, trypsin, chymotrypsin, rutoside;
• merkenzim - pancreatin, bromelain, bile;
• phlogenzym - bromelain, trypsin, rutoside.

They are prescribed for allergies to animal proteins. However, plant enzymes cannot be used for bronchial asthma and allergies to fungi and to antibiotics of the penicillin series. Plant enzymes not found wide application, because 75 times less effective than animals.

5. pancreatic and plant enzymes (wobenzym, phlogenzym)

Separately worth combination drug Panzinorm. It contains pancreatic enzymes, pepsin and amino acids and can be used in patients with low acidity, dysfunction of the pancreas and bile secretion.

How to choose an enzyme preparation

• depending on the acidity of gastric juice: with reduced acidity, panzinorm forte is indicated, in other cases other drugs can be used;
• with insufficient bile secretion, complexes of enzymes and bile are used;
• preparations containing simethicone or dimethicone are well suited for patients with flatulence and IBS (Pepfiz, Unienzyme);
• in children, with pancreatitis mild degree, episodic overeating, chronic gastritis and enterocolitis, functional dyspepsia, dysfunction of the gallbladder, plant enzymes can be used.

It must be remembered that in the first 7-10 days of acute pancreatitis (and 3-5 days of exacerbation of chronic), as well as allergies to animal protein, you should refrain from prescribing and taking enzymes!

If enzymes are effective...

... the stool is normalized, fats, starch and undigested muscle fibers(creatorrhoea), body weight is normalized.

The dose is selected individually during the week, you can start with 1000 IU of lipase per 1 kg of body weight per day, that is, 60,000-70,000 IU, divided into 3-4 meals. When severe violations the dose is increased to 4000-5000 IU. The drug is stopped after the disappearance of symptoms and violations in the coprogram.

If Enzymes Are Ineffective...

…so there are several reasons for this:

• insufficient dosage, improper storage with loss of enzyme activity, improper intake;
• inactivation of enzymes in the acidic contents of the stomach or duodenum;
• dysbacteriosis.

When is diarrhea and steatorrhea slow to go away?

With IBS and organic pathology Intestinal absorption of fats during normal digestion may be impaired, while fat in the stool remains. In this case, it is necessary to increase the dose of the drug.

With high acidity of gastric and intestinal contents, bile does not emulsify fats well, and enzymes are inactive, which also causes steatorrhea. Antacids and proton pump inhibitors help here.

And finally, if the enzyme leaves the stomach at the same time as food, this can also cause problems that can be solved. the right way(on an empty stomach or during meals, in no case after, because this nullifies their effect) and the use of microencapsulated forms. Creon and similar drugs contain particles less than 2 mm in diameter, which allows for parietal digestion and simultaneous release of the enzyme from the stomach - along with portions of food).