Digestion begins when a person chews food. Saliva contains amylase, which breaks down polysaccharides. The stomach produces about 1.5-2 liters every day. gastric juice, which contains pepsin (thanks to this enzyme, proteins are broken down to peptides) and HCl (pepsin activity is possible only in acidic environment). The gastric chyme in the duodenum is processed by pancreatic enzymes and bile.

Enzymes that are responsible for the digestion process

The pancreas produces about 20 digestive enzymes and. The main ones can be called:

• Proteolytic: elastase, peptidase, chymotrypsin, trypsin (contribute to the breakdown of peptides and proteins to amino acids). Their release occurs in the form of proenzymes, for example, trypsinogen, etc. (otherwise the gland would self-digest). Activation of proenzymes in the intestine occurs with the help of enterokinases.
• Lipolytic: lipase (promotes the breakdown of triglycerides to fatty acids and monoglycerides; its activity is possible only in the presence of bile acids that emulsify fats) and phospholipase (promotes the breakdown of lecithin and phospholipids).
• Amylolytic: amylase (promotes the breakdown of starch and other polysaccharides to disaccharides; in turn, disaccharides are broken down to monosaccharides due to small intestine enzymes - invertase, lactase, maltase, etc.).
• Nucleolytic: deoxyribonuclease and ribonuclease (contribute to the breakdown of nucleic acids; their release occurs in a small amount).

Pancreatic enzymes are active only in alkaline environment. Pancreatic juice includes bicarbonates that neutralize acidic gastric contents in the duodenum.

Passing through the membrane of enterocytes, fermentation products are absorbed in the upper intestine. Our body does not have enzymes that break down plant fiber - hemicellulase and cellulase. Fermentation of plant fibers by microorganisms of the large intestine is accompanied by the formation of some useful substances, for example, sugars, acids, and a certain amount of gases that stimulate the work of the intestines.

Enzyme preparations

Preparations containing pancreatic enzymes have been produced for over a hundred years. Their main components, as a rule, are amylase, protease and lipase contained in pancreatin, a powder obtained from the porcine pancreas. The assessment of enzyme activity is carried out taking into account the units of the European Pharmacopoeia or International units (they are identical). The activity of lipase of one mg of dry pancreatin varies from 15 to 45 units. Protease, amylase and lipase are contained in the preparations in optimal proportions (the preparation should not contain many proteases, since they reduce the activity of lipase).

Preparations containing enzymes are prescribed in the most various occasions digestive disorders. As a rule, they help to eliminate the maldigestion syndrome (a feeling of heaviness and discomfort, and diarrhea, flatulence, polyfecal matter, belching, nausea, etc.), pain. In addition, they are well tolerated and practically do not have side effects and contraindications.

Enzyme preparations are indicated for use in many cases. They can be accepted with gastric diseases (chronic gastritis, characterized by reduced secretory function, condition after gastric resection, etc.), diseases of the gallbladder, liver (condition after cholecystectomy, chronic cholecystitis, chronic hepatitis), diseases of the pancreas (cystic fibrosis, chronic, etc.), intestinal diseases (chronic enterocolitis and enteritis) functional dyspepsia, violation of parietal digestion (Crohn's disease, deficiency of disaccharidases, celiac enteropathy), etc.

Enzyme preparations are indicated for use mainly in people suffering from chronic pancreatitis, characterized by impaired exocrine function, as well as in patients who have undergone pancreatic resection. Ensuring normal digestion is possible when the body receives a sufficient amount of lipase (at least 400 thousand IU daily). When choosing a remedy, one should first of all pay attention to the activity of lipase, since the secretion and production of lipase is most disturbed. It is vital for a patient who has completely removed the pancreas to take medicines containing a large number of enzymes.

See also vigeratin, cholenzim.

ABOMIN (Abominum)

A preparation obtained from the gastric mucosa of calves and lambs of milk age; contains a sum of proteolytic (protein-splitting) enzymes.

Pharmachologic effect. It has proteolytic activity.

Indications for use. Diseases gastrointestinal tract, accompanied by a violation of the digestive capacity and a decrease in the acidity of gastric juice: gastritis (inflammation of the gastric mucosa), gastroenteritis (inflammation of the mucous membranes

lining of the stomach and small intestine), enterocolitis (combined inflammation of the small and large intestine), etc.

Method of application and dose. Inside during meals, 1 tablet 3 times a day for 1-2 months; with insufficient efficiency single dose increase to 3 tablets, and the course of treatment is extended to 3 months. At acute gastritis, gastroenteritis, colitis appoint 1 tablet 3 times a day for 2-3 days.

Side effect. In some cases mild nausea, heartburn.

Contraindications. Obstruction of the gastrointestinal tract,

Release form. Tablets of 50,000 units, in a package of 10 pieces.

Storage conditions. In a cool, dry, dark place.

ALPHA-AMILASE (Alpha-amylase)

Pharmachologic effect. Alhalolytic (breaking down starch, glycogen and related compounds) enzyme. Optimizes the digestion of carbohydrates.

Indications for use. Pancreatic insufficiency, indigestion; operations on the pancreas, intestines, liver and stomach.

Method of application and dose. The dose is selected individually. Used in conjunction with other enzymes orally during or after meals.

Release form. Powder.

Storage conditions. In a dry place at temperatures from 0 to +5 "C.

VESTAL (Vestalum)

Pharmachologic effect. A complex enzyme preparation that stimulates digestion.

Indications for use. Insufficient secretory (insufficient secretion of digestive juices) and digestive capacity of the gastrointestinal tract, digestive disorders associated with diet or overeating, gastritis (inflammation of the stomach), pancreatitis (inflammation of the pancreas), hepatitis (inflammation of the liver tissue), cholecystitis (inflammation of the bile bubbles), etc.

Method of application and dose. Inside, 1-3 tablets during meals or immediately after meals 3 times a day.

Release form. Film-coated tablets in a pack of 50 pieces.

Storage conditions. In a cool place.

GASTRIC JUICE NATURAL (Succus gastricus naturalis)

The secret of the gastric glands (gastric juice) healthy dogs and other pets, canned with 0.03-0.04% salicylic acid.

Indications for use. With insufficient function of the gastric glands, achilia (lack of secretion of hydrochloric acid and enzymes in the stomach), hypoanacid gastritis (inflammation of the stomach, accompanied by a decrease in the level or absence of hydrochloric acid), dyspepsia (digestive disorders).

Method of application and dose. Assign inside during or after meals 2-3 times a day, 1-2 tablespoons (children depending on age from "/2 teaspoon to 1 tablespoon).

Release form. Natural juice from dogs in bottles of 100 ml. Juice natural from konshekvin - in bottles of 100 ml.

Storage conditions. In a place protected from light at a temperature of +2 to +10 °C.

LACTRASE (Lactrase)

Synonyms: Trilactase.

Pharmachologic effect. Digestive enzyme, which is lactase (disaccharidase), which is located in the alkaline border of the mucous membrane jejunum and proximal (initial) department ileum(section of the small intestine). During digestion, it breaks down lactose into simple sugars (galactose and glucose), which are absorbed in the intestines.

Indications for use. Lactase deficiency varying degrees severity (hypolactasia, analactasia).

Method of application and dose. Assign inside 250-500 mg before drinking milk or dairy products. If necessary, increase the dose. In patients with diabetes the need for the use of lactase will be determined by the doctor. It should be taken into account that from 2 liters of milk, when lactose is broken down, 25 g of glucose and 25 g of galactose are formed.

The drug can be added to food containing lactose. To do this, the contents of the capsule should be poured into ready meal. The drug can be added to milk in advance, for this you should dissolve the contents of 1-2 capsules in 1 liter of milk, mix and refrigerate for 24 hours.

Side effect. Rarely - a feeling of discomfort in the epigastrium (the area of ​​\u200b\u200bthe abdomen, located directly under the convergence of the costal tubes and the sternum).

Contraindications. Hypersensitivity to the drug.

Release form. Capsules of 250 mg in a package of 10 and 30 pieces.

Storage conditions. In a dry, cool place.

NIGEDASA (Nigedasa)

The drug is isolated from the seeds of Nigella Damascus (Nigelladamascena).

Pharmachologic effect. An enzyme of lipolytic action (decomposing fats), causes hydrolytic cleavage (decomposition with the participation of water) of fats of vegetable and animal origin.

Indications for use. To compensate for the missing or absent lipolytic activity of duodenal juice (digestive juices secreted by the duodenum), caused by pathology (disease) of the digestive organs (pancreatitis - inflammation of the pancreas, cholecystopancreatitis - combined inflammation of the gallbladder and pancreas, chronic hepatitis - inflammation of the liver tissue, chronic gastritis - inflammation of the gastric mucosa enterocolitis - inflammation of the small and large intestine, etc.).

Method of application and dose. Inside, 1-2 tablets for 10-30 minutes. before meals, drinking water, with achilia (lack of secretion of hydrochloric acid and enzymes in the stomach), hypo- and anacid conditions (decrease in the level or absence of hydrochloric acid in the stomach) - 1-2 tablespoons of natural gastric juice. The course of treatment is 3-4 weeks, if necessary, can be longer.

Side effect. In patients chronic colitis(inflammation of the colon), abdominal pain may appear, which disappears with a decrease in the dose.

Release form. Tablets of 0.15 g, soluble in the intestine, in a package of 30 pieces.

Storage conditions. At a temperature not higher than +10 °C,

ORAZA (Orazum)

Pharmachologic effect. An acid-resistant complex of amylolytic (polysaccharide-degrading) and proteolytic (protein-degrading) enzymes that promote the digestion of essential nutrients.

Indications for use. Gastritis (inflammation of the stomach lining) low acidity, chronic hepatocholecystitis (combined inflammation of the tissues of the liver and biliary tract), peptic ulcer stomach with reduced secretion (with reduced formation of gastric juice), subacute and chronic pancreatitis (inflammation of the pancreas).

chronic spastic colitis (inflammation of the colon, characterized by sharp painful contractions) with a tendency to constipation.

Method of application and dose. Inside, 1/2-1 teaspoon during or immediately after meals 3 times a day. The course of treatment is 2-4 weeks.

Side effect. In patients suffering from diarrhea (diarrhea), diarrhea may increase.

Release form. Granules in jars of 100 g.

Storage conditions. In a cool dry place.

PANCREATIN (Pancreatinum)

Synonyms: Pantsitrat.

Pharmachologic effect. Included in the drug pancreatic enzymes(pancreatic enzymes) - amylase, lipase and protease facilitate the digestion of carbohydrates, fats and proteins, which contributes to their more complete absorption v small intestine. In diseases of the pancreas, the drug compensates for its insufficiency. secretory function(highlights digestive juice) and improves the digestion process.

Indications for use. Insufficiency of the secretory function of the pancreas (chronic pancreatitis - inflammation of the pancreas, cystic fibrosis - hereditary disease characterized by blockage of the output ducts of the pancreas, glands respiratory tract and intestines, viscous secretions, etc.). Chronic inflammatory-dystrophic diseases of the stomach, intestines, liver, gallbladder; conditions after resection (removal of part of an organ) or irradiation of these organs, accompanied by impaired digestion of food, flatulence (accumulation of gases in the intestines), diarrhea (diarrhea) - as part of combination therapy. Condition after pancreatectomy (removal of the pancreas). Obstruction (impaired patency) of the pancreatic ducts or biliary tract. To improve digestion, write in patients with normal function gastrointestinal tract in case of violation of the diet, as well as in violation of the chewing function, forced prolonged immobilization(immobilization), sedentary manner life. Preparation for x-ray and ultrasound examination of the abdominal organs.

Method of application and dose. The dose of the drug (in terms of lipase) depends on the age and degree of pancreatic insufficiency. The average dose for adults is 150,000 IU / day. With complete insufficiency of the secretory function of the pancreas - 400,000 units / day, which corresponds to daily requirement adult human in lipase. The maximum daily dose is 15 GOO-20,000 IU/kg of body weight.

Children under the age of 1.5 years are prescribed 50,000 IU / day; older than 1.5 years - 100,000 IU / day.

In cystic fibrosis, the dose of the drug is selected individually. The dose should be adequate to the amount of enzymes required for fat absorption, taking into account the quality and quantity of food consumed.

Tablets, capsules or dragees are taken with meals, swallowed whole with water. large quantity non-alkaline liquids (water, fruit juices). To facilitate swallowing and improve absorption of the drug used in capsules, especially in patients after gastric resection, you can open the capsule and swallow its contents without chewing.

The duration of treatment can vary from several days (in case of indigestion due to errors in the diet) to several months and even years (if permanent replacement therapy is necessary).

Side effect. Acute pancreatitis (inflammation of the pancreas). At long-term use very rarely hypersensitivity reactions are possible. In some cases, allergic reactions are observed immediate type, as well as allergic reactions from digestive tract. With prolonged use high doses the drug may develop hyperuricosuria ( increased content uric acid in the urine). With cystic fibrosis, after taking large doses, sometimes there is the formation of strictures (narrowings) in the ileocecal region (the junction of the large and small intestines) and in colon(section of the large intestine).

Contraindications. Acute pancreatitis, exacerbation of chronic pancreatitis, hypersensitivity to the components of the drug.

Release form. Tablets. Capsules. Dragee. Gelatin capsules containing enteric-coated microtablets containing 10,000, 20,000 or 25,000 units of lipase; amylase at 9000, 18,000 or 22,500 IU; protease 500, 1000 or 1250 IU.

Storage conditions. In a dry, cool place.

WOBENZIM (Vobenzmuin)

Pharmachologic effect. A complex enzyme preparation that improves digestion.

Indications for use. Digestive disorders, insufficiency of the secretory function (excretion of digestive juices) of the pancreas, gallbladder, liver, pancreatitis (inflammation of the pancreas), etc.

Method of application and dose. Inside, 1 tablet 3 times a day with meals with a little water.

Side effects and contraindications are the same as for the drug pangrol 400 (see page 346).

Release form. Film-coated tablets in a pack of 20 or 50 pieces. 1 tablet contains: pancreatin - 0.1 g, papain - 0.06 g, bromelain - 0.045 g, lipase - 0.01 g, trypsin - 0.024 g, chymotrypsin - 0.0001 g, rutin - 0.05 g.

Storage conditions. In a dry, cool place.

MEZIM-FORTE (Mezym-forte)

Pharmachologic effect. Provides good digestibility of fats, proteins and carbohydrates.

Indications for use. With insufficient secretory (insufficient formation of digestive juices) and digestive capacity of the stomach and intestines (with chronic gastritis - inflammation of the gastric mucosa, enterocolitis - a combination of inflammation of the small and large intestine, etc.), with chronic pancreatitis (inflammation of the pancreas), hepatitis (inflammation liver tissue), cholecystitis (inflammation of the gallbladder).

Method of application and dose. Assign adults to 1-3 tablets per day (before taking write).

Release form. Coated dragees in a pack of 20 pieces. Composition: 140 mg of pancreatin, 4200 IU of amylase, 3500 IU of lipase and 250 IU of proteases.

Storage conditions. Ordinary.

PANGROL 400 (Pangrolum400)

Pharmachologic effect. enzyme preparation. Normalizes digestion.

Indications for use. Digestive disorders with pancreatic insufficiency (chronic pancreatitis - inflammation of the pancreas, fibrosis - proliferation of connective tissue

pancreas), resection (removal of part of an organ) of the stomach or small intestine, accelerated passage of food through the intestines, flatulence (accumulation of gases in the intestines).

Method of application and dose. Inside before or during meals, 1-2 tablets.

Side effect. V rare cases diarrhea (diarrhea) is possible.

Contraindications. Hepatitis (inflammation of the liver tissue), obstructive jaundice (jaundice associated with a mechanical obstruction to the outflow of bile through the biliary tract), intestinal obstruction, hypersensitivity to the drug.

Release form. Coated tablets containing pancreatin with an activity of amylase 12,000 IU, lipase 16,000 IU and proteinases 720 IU, 0.4 g each.

Storage conditions. In a dry, cool place.

PANZINORMFORT (Panzinorm forte)

Pharmachologic effect. Replaces the enzymes of the stomach and pancreas and stimulates their release.

Indications for use. Digestive disorders of various origins, hypofunction (decreased function) of the pancreas, atrophic gastritis(inflammation of the stomach with thinning of the mucous membrane), gastroduodenitis (inflammation of the stomach and duodenum), hepatitis (inflammation of the liver tissue), cholecystitis (inflammation of the gallbladder), after operations on the gastrointestinal tract, pancreas and liver.

Method of application and dose. Inside, 1 tablet during meals 3 times a day.

Side effects and contraindications are the same as for the drug pangrol 400.

Release form. Tablets in a package of 30 pieces. Composition of 1 tablet: extract of the gastric mucosa - 200 mg (corresponding to 200 mg of pepsin), dry extract of bile cattle- 30 mg, pancreatin - 200 mg. The outer shell of the tablet contains an extract of the gastric mucosa, which is released in the stomach; the core of the tablet containing pancreatin and bile disintegrates in the duodenum.

Storage conditions. In a cool place.

PANKURMEN (Pancurmen)

Pharmachologic effect. Combined drug. The digestive enzymes included in its composition facilitate the digestion of proteins, fats, carbohydrates, which contributes to their more complete absorption in the small intestine. Turmeric extract, which is part of the drug, has a choleretic (increasing the formation of bile) and a weak cholekinetic (facilitating the release of bile into the intestines) action. Bile promotes fat emulsification, increases lipase activity, improves fat absorption and fat soluble vitamins A, E, K. The use of the drug leads to an improvement functional state gastrointestinal tract, normalization of digestion.

Indications for use. Failure exocrine function(secretion of digestive enzymes) of the pancreas: chronic pancreatitis (inflammation of the pancreas), cystic fibrosis ( congenital disease manifested by chronic pneumonia and digestive disorders), etc. Chronic inflammatory-dystrophic diseases of the stomach, intestines, liver, gallbladder; conditions after resection (removal of part of an organ) or irradiation of these organs, accompanied by impaired digestion of food, flatulence (accumulation of gases in the intestines), diarrhea (as part of combination therapy). To improve the digestion of food in patients with normal function of the gastrointestinal tract in case of nutritional errors, as well as in violation of chewing function, forced prolonged immobilization (immobilization), sedentary lifestyle. Preparation for x-ray and ultrasound examination of the abdominal organs.

Method of application and dose. Assign 2-4 tablets 3 times a day before meals or during meals. The dragee should be swallowed whole, without chewing and with a small amount of liquid. The duration of treatment can vary from several days (in case of indigestion due to nutritional errors) to several months and even years (if permanent replacement therapy is necessary).

Side effect. In rare cases, diarrhea (diarrhea), nausea is possible.

Contraindications. Hepatitis (inflammation of the liver tissue), obstructive jaundice (jaundice associated with a mechanical obstruction to the outflow of bile through the biliary tract), intestinal obstruction, hypersensitivity to the drug.

Release form. Film-coated tablets, 20 pieces per pack. 1 tablet contains 0.035 g of pancreatin (amylase 1050 IU FIP, lipase 875 IU FIP, protease 63 IU FIP) and 0.0085 g of turmeric extract.

Storage conditions. In a dry place protected from light.

Panstal (Panstalum)

Pharmachologic effect. Complex enzyme preparation that promotes digestion.

Indications for use. Digestive disorders associated with diseases of the duodenum and gallbladder, gastroenteritis (inflammation of the mucous membranes of the stomach and small intestine), flatulence (gas accumulation in the intestines) after cholecystectomy (removal of the gallbladder), taking fatty food, during the period of adaptation after dental prosthetics.

Method of application and dose. Inside, 1-2 tablets 3 times a day during or immediately after meals.

Contraindications. Acute diseases liver, hepatic coma, obstruction (blockage) of the bile duct, emphysema of the gallbladder (stretching of the gallbladder by the gases formed in it), intestinal obstruction.

Release form. Tablets, soluble in the intestine, and containing 0.192 g of pancreatin, 0.05 g of hemicillulase and 0.025 g of ox bile extract, in a package of 100 pieces.

Storage conditions. In a dry place.

PROLIPASE (Prolipase)

Pharmachologic effect. The drug contains pancreatic (secreted by the pancreas) enzymes. Normalizes digestion.

Indications for use. Exocrine insufficiency (insufficient secretion of digestive juices) of the pancreas, stomach, liver, gallbladder; flatulence (accumulation of gases in the intestines); diarrhea (diarrhea) of a non-infectious nature; chewing dysfunction.

Method of application and dose. Inside, 1-2 capsules (without chewing) during a meal and 1 capsule in between meals, write.

Side effect. Allergic reactions, diarrhea, hyperuricosuria (increased excretion of uric acid in the urine).

Contraindications. Hypersensitivity to the drug.

Release form. Capsules in a package of 100 pieces. 1 capsule contains pancreatic enzymes with the activity of lipase 4000 IU, amylase 2000 IU and protease 25 000 IU.

Storage conditions. In a cool dry place.

TAGESTAL (Tagestalum)

Pharmachologic effect. Complex preparation containing pancreatin, hemicellulase and ox bile extract. Normalizes digestion.

Indications for use. Digestive disorders associated with diseases of the pancreas, gallbladder, liver, heavy consumption fatty foods, gastroenteritis (inflammation of the mucous membranes of the stomach and small intestine), to remove gases before radiological and ultrasound examinations.

Method of application and dose. Inside during or immediately after meals, 1-2 tablets 3 times a day; before X-ray radiological procedures take 2 tablets 2-3 times a day for 2-3 days.

Side effect. Allergic reactions.

Contraindications. Hypersensitivity to the drug, severe liver dysfunction, high level bilirubin (bile pigment).

Release form. Dragees containing 0.192 mg of pancreatin, 0.05 g of hemicellulase and 0.025 g of ox bile extract, in a package of 100 pieces.

Storage conditions. In a cool dry place.

TRIFERMENT (Trifermentum)

Pharmachologic effect. A preparation containing the enzymes trypsin, lipase and amylase. Replenishes the deficiency of digestive enzymes in the body.

Indications for use. Lack of secretory (excretion of digestive juices) and digestive capacity of the stomach and intestines (chronic gastritis - inflammation of the stomach, colitis - inflammation of the colon), chronic pancreatitis (inflammation of the pancreas), hepatitis (inflammation of the liver tissue), cholecystitis (inflammation of the gallbladder).

Method of application and dose. Inside before meals for adults, 1-3 tablets per day; children 1-2 tablets a day.

Side effects and contraindications are the same as for the drug pangrol 400.

Release form. Coated dragees, pack of 30 pieces. 1 dragee contains trypsin 18 U, lipase 6 U, amylase (1:10).

Storage conditions. In a dry place protected from light.

FESTAL (Festal)

Synonyms: Digestal.

Pharmachologic effect. Preparation of standardized pancreatic (secreted by the pancreas) enzymes (lipase, amylase, protease), hemicellulase and dried ox bile. Promotes the breakdown and assimilation of products containing fats, proteins, carbohydrates and vegetable ballast substances (hemicellulase).

Indications for use. Relative or absolute pancreatic insufficiency (insufficient secretion of digestive enzymes by the pancreas) various etiologies(causes); flatulence (accumulation of gases in the intestines) due to cholecystitis (inflammation of the gallbladder); bowel aeration (cleansing) before x-ray; gastrointestinal disorders ( gastrointestinal disorders) as a result of treatment with para-aminosalicylic acid and broad-spectrum antibiotics

actions, damage to the chewing apparatus; indigestion in old age.

Method of application and dose. Inside, 1-2 tablets during or after meals 3 times a day.

Contraindications. Hepatitis (inflammation of the liver tissue), obstructive jaundice (jaundice caused by blockage of the bile ducts).

Release form. Dragees containing pancreatin 0.02 g, bovine bile extract 0.025 g and hemicellulase 0.05 mg, in a package of 30 pieces and 100 pieces.

Storage conditions. In a dry, cool, dark place.

ENZISTAL (Enzystalum)

Pharmachologic effect. An enzyme preparation containing pancreatin, hemicellulase and bile components. Normalizes digestion.

Indications for use. Insufficiency of exocrine function (secretion of digestive juices) of the pancreas, stomach, intestines, liver; flatulence (accumulation of gases in the intestines); diarrhea (diarrhea) of a non-infectious nature; to improve digestion in persons with normal function of the gastrointestinal tract with violations of the chewing apparatus, sedentary lifestyle, prolonged immobilization (immobilization); preparation for x-ray ultrasound research abdominal organs.

Method of application and dose. Inside, 1-2 tablets 3 times a day during or after meals for weeks, months and even years.

Side effect. Nausea, diarrhea.

Contraindications. Hepatitis (inflammation of the liver tissue), obstructive jaundice (jaundice caused by blockage of the bile ducts), intestinal obstruction, hypersensitivity to the drug.

Release form. Dragees containing 0.192 g of pancreatin, 0.05 g of hemicellulase and 0.025 g of bile components, in a package of 10 pieces.

Storage conditions. In a dry place protected from light.

Pancreatin is also part of vigeratin, mexase, pancreoflat preparations.

PEPSIN (Pepsinum)

Indications for use. With digestive disorders (achilia, lack of secretion of hydrochloric acid and enzymes in the stomach, hypo- and anacid gastritis - inflammation of the stomach, accompanied by a decrease in the level or absence of hydrochloric acid, dyspepsia - digestive disorders, etc.).

Method of application and dose. Inside before or during meals, 0.2-0.5 g (children from 0.05 to 0.3 g) 2-3 times a day in powder or in a 1-3% solution of diluted hydrochloric acid.

Release form. Powder.

Storage conditions. In a cool, dark place.

ACIDIN-PEPSIN (Acidin-pepsinum)

Synonyms: Betacid, Acipepsol, Pepsamin.

Pharmachologic effect. Combined drug. Helps digest food in the stomach.

Indications for use. With hypo- and anacid gastritis (inflammation of the stomach, accompanied by a decrease in the level or absence of hydrochloric acid), achilia (lack of secretion of hydrochloric acid and enzymes in the stomach), dyspepsia (digestive disorders).

Method of application and dose. Inside during or after meals in "/4-"/2 glasses of water, 1-2 tablets 3-4 times a day; children (depending on age) from 1/4 tablet to 1 tablet 3-4 times a day.

Release form. Tablets of 0.25 g in a package of 50 pieces. Ingredients: pepsin - 1 part, betaine hydrochloride - 4 parts.

Storage conditions. Ordinary.

PEPSIDIL (Pepsidilum)

A solution in hydrochloric acid of the products of enzymatic hydrolysis (decomposition with the participation of water, catalyzed / accelerated / by the enzyme) of the tissue of the mucous membrane of the stomach of pigs, containing all the components of the secretion of the gastric glands (gastric juice).

Pharmachologic effect. Pepsin - the main therapeutic factor of the drug - determines the digestion of proteins in the stomach.

Indications for use. Hypacid and anacid gastritis (inflammation of the stomach, accompanied by a decrease in the level or absence of hydrochloric acid).

Method of application and dose. Inside during meals, 1-2 tablespoons (preferably through a tube) 3 times a day.

Release form. In vials of 450 ml.

Storage conditions. At a temperature of +4 "C.

PLANTEKS (Plantex)

Pharmachologic effect. A preparation containing plant components for the correction of digestive disorders in children. The fruits and essential oil of fennel, which are part of the plantex, have a stimulating digestion and carminative effect. Stimulate digestion by increasing the secretion of gastric juice and peristalsis ( undulating movements intestines). The drug prevents gas formation in the intestines and increases the excretion of gases and, thus, relieves spasms caused by intestinal flatulence (accumulation of gases in the intestines).

Indications for use. Correction of digestive disorders in children, including infancy.

Method of application and dose. For infants, the contents of the sachet (5 g) are poured into a baby bottle for feeding, topped up with 100 ml of freshly boiled water or milk and shaken until the tea is dissolved. Cool to room temperature before use.

Children over 1 year old in a cup containing 100-150 ml of boiled warm or cold water, pour 1-2 bags (5-10 g) of tea and mix to dissolve. Tea is not sweetened.

Side effect. In rare cases, hypersensitivity reactions are possible.

Contraindications. Hypersensitivity to the components of the drug.

Release form. Dry matter for making tea in sachets of 5 g. 1 sachet contains: fennel fruit extract - 2.75 g, fennel fragrance with 16% essential oil- 0.015 g, glucose - 2.5 g, lactose - 2.235 g. The calorie content of tea (made from one bag) is 19 kcal.

Storage conditions. In a dry place.

SOLIZIM (Solizymum)

Lipolytic (decomposing fats) enzyme preparation obtained from the culture of Penicillium solitum.

Pharmachologic effect. Hydrolyzes (decomposes with the participation of water) vegetable and animal fats; promotes digestion and absorption of fats.

Indications for use. Chronic pancreatitis (inflammation of the pancreas) with a decrease in lipolytic activity; chronic diseases of the gastrointestinal tract: gastritis (inflammation of the stomach), hepatitis (inflammation of the liver tissue), cholecystitis (inflammation of the gallbladder), enteritis (inflammation of the small intestine), enterocolitis (inflammation of the small and large intestine); after operations on the pancreas, intestines, gallbladder.

Method of application and dose. Inside during or immediately after a meal, 40,000 LE (lipolytic units) 3 times a day. Daily dose- LE 120,000. The course of treatment is 2-4 weeks.

Release form. Tablets of 20,000 LE, soluble in the intestine, in a package of 50 pieces.

Storage conditions. In a dry, dark place at a temperature not exceeding +4 °C.

SOMILAZA (Somilasum)

Combined preparation, which includes solyzyme (lipolytic / decomposing fats / enzyme obtained from the culture fluid of Peniciliumsolutum) and alpha-amylase obtained from aminosubtilin.

Pharmachologic effect. Hydrolyzes (decomposes with the participation of water) vegetable and animal fats and breaks down polysaccharides, resulting in compensation for enzymatic insufficiency of digestion.

Indications for use. Pancreatic insufficiency, leading to a decrease in lipolytic and amylalytic activity (the ability to decompose fats and polysaccharides) of duodenal contents (duodenal contents) in chronic pancreatitis (inflammation of the pancreas); digestive insufficiency: gastritis (inflammation of the stomach), enteritis (inflammation of the small intestine), enterocolitis (inflammation of the small and large intestine), hepatitis (inflammation of the liver tissue), cholecystitis (inflammation of the gallbladder); after operations on the pancreas, intestines, liver, stomach; at functional disorders related to diet.

Method of application and dose. Inside during meals or immediately after meals, 1-2 tablets 3 times a day (the tablet is swallowed whole without chewing) daily.

Side effects and contraindications have not been identified.

Release form. Tablets, soluble in the intestines, containing 20,000 LE (0.0286 g) of solisim and 300 IU (0.1363 g) of alphamylase, 50 pieces in a package.

Storage conditions. In a dry, dark place at a temperature not higher than +5 °C, not lower than 0 °C.

UNIENZYM (Unienzymum)

Pharmachologic effect. Normalizes digestion. It has an adsorbing (absorbing) effect.

Indications for use. Digestive disorders, flatulence (accumulation of gases in the intestines).

Method of application and dose. Inside, 1-2 tablets, without chewing, during or immediately after a meal.

Side effects and contraindications have not been identified.

Release form. Film-coated tablets in packs of 30 and 100 pieces. 1 tablet contains: diastase - 0.02 g, papain - 0.03 g, simethicone - 0.05 g, nicotinamide (vit. PP) - 0.025 g and activated carbon- 0.075 g.

Storage conditions. In a place protected from light.

Preparations containing digestive enzymes are currently widely used in the treatment of diseases of the 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. the breakdown of food during exocrine insufficiency pancreas, 2. reduction of 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 its own enzymes are destroyed by microorganisms that seed the thin and duodenum, with peptic ulcer 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 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 of the 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.
Solizim and somilase are contraindicated in case of allergy to penicillin antibiotics.

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 activity own glands secretions.

Enzyme preparations are medicines designed to improve digestion and contain special elements (enzymes). The human body produces the substances necessary for food to be properly digested and assimilated, but sometimes they are not enough, which leads to bloating and gas formation. In order to get rid of similar problems, appoint enzyme preparations, thanks to which digestion is normalized and well-being improves. Medicines are taken long time to achieve a certain effect.

Indications for use

The digestion process may be impaired due to malnutrition, and also due to the presence serious illnesses gastrointestinal tract. Enzyme preparations are prescribed in addition to the main drugs in order to improve the patient's condition. They are recommended for the following diseases:

• chronic gastritis, pancreatitis, cholecystitis;
• enterocolitis, Crohn's disease, functional dyspepsia.

Enzymes are especially needed for the pancreas when a chronic type of pancreatitis develops.

Types of enzyme preparations

There are many different enzyme preparations, their choice depends on the severity of the disease, and the dosage can only be prescribed by a doctor who has studied the picture of the disease. The drug is selected according to criteria such as:

• the presence of digestive enzymes that promote the digestion of nutrients;
• form of production;
• the immutability of enzymes when exposed to hydrochloric acid;
• effective penetration of enzymes through the duodenum;
• good tolerability of the drug, the presence or absence of contraindications;
• shelf life and affordability.

Distinguish the following types enzyme preparations:

1. Extracts of the gastric mucosa, they include pepsin (Abomin, Acidin-pepsin).
2. Pancreatic substances, including amylase, lipase and trypsin (Pancreatin, Creon, Mezim).
3. Mixed enzymes that combine pancreatin with bile components, hemicellulase (Festal, Enzistal).
4. Herbal preparations supplemented with fungal amylase, papain, lipase (Pepfiz, Oraza).
5. Disaccharidase (Thylactase).

When choosing medicines to improve digestion, the type of pathology and the severity of its course are taken into account. The main substances in the preparations are lipase, protease and pancreatin amylase. They are packaged in an acid-resistant capsule so that they do not dissolve in hydrochloric acid contained in gastric juice. With pancreatitis, Creon, Pancitrate are usually prescribed, when they are taken, enzymes quickly pass through the duodenum and are mixed with food. Some enzymatic agents chronic pancreatitis cannot be used. This applies to medicines containing bile: Festal, Digestal. Preparations must be harmless and non-toxic so as not to harm the body.

Pancreatic enzymes are essential for correct operation digestive organs. In case of their insufficiency, it is required drug treatment with a special diet. In such a situation, the following drugs are prescribed:

• Pancreatin, Creon;
• Mezim, pangrol;
• Digestal.

Plant enzymes are recommended for people who cannot tolerate pancreatic enzymes due to allergies to pork or beef. Such medicines contain papain, an extract of rice fungus. The activity of fungal and plant enzymes is less than that of animals, so they are less popular.

Antienzymatic drugs are prescribed to suppress the activity of these substances. The following are popular: Gordoks, Pantripin.

Appointment and treatment

Dosage medicinal product selected individually for each person. If deterioration occurs, the drug is canceled and another one is prescribed, similar in pharmacological action.

The following medications are commonly used to treat and prevent pancreatic dysfunction:

• Panzinorm, mezim;
• Festal, Creon;
• Pancreatin.

In chronic pancreatitis, enzymes are prescribed to improve activity digestive system and reduce discomfort and pain. These include No-Shpu, Papaverine.

Contraindications and restrictions

Enzymes are not taken in acute pancreatitis and during exacerbation chronic form diseases. There are restrictions in case of allergies to meat (pork, beef). Like all medicines, these drugs have contraindications. They should not be taken when there are such pathologies in the anamnesis:

• gout;
• celiac disease;
• acute gastritis, pancreatitis.

It is undesirable to take enzymes with an excess of uric acid formation (hyperuricosuria), when it develops urolithiasis disease. When overdosed, they appear characteristic symptoms: diarrhea, constipation, nausea, stomach pain. In addition, products containing bile components are not recommended for such diseases as:

• acute and chronic pancreatitis;
• hepatitis of any kind;
• diarrhea, gastric ulcer and duodenal ulcer;
• inflammation of the intestinal tract.

Digestive enzymes in preparations based on plant components are widely used to treat children, they are diluted in liquids, in food. They are used in chronic gastritis, enteritis and mild form pancreatitis. Tablets based on animal products are prescribed to children for the treatment of gastric diseases associated with digestive problems. The dose and frequency of administration for each child are set individually, depending on the form of the disease. They can only be used as directed by a doctor. In addition, they adhere special diet, accept others medications to reduce inflammation.

Any enzyme preparations - both for adults and children - are used only on the recommendation of a specialist.

More than 3,000 enzymes are known to science, while some experts believe that there are many more - up to 50,000. Each enzyme performs a specific function, like a key that opens a specific lock, i.e. launches a specific biochemical reaction. Enzymes consist of amino acids and are secreted in the body to speed up reactions that would otherwise not occur at physiological temperatures human body. Today the site will talk about digestive enzymes, the consequences of their lack and ways to stimulate their production.

Digestive enzymes - each has a role

It is worth noting that enzymes are important for every cell of the body and are involved not only in the digestive system, but in all physiological processes. Enzymes start biological processes, necessary for the body for transportation nutrients, removing toxins and performing other functions, namely:

• power generation;
• oxygen absorption;
• fight infections;
• wound healing;
• suppression of inflammatory processes;
• supply of nutrients to cells;
• elimination of toxins;
• breakdown of fats, regulation of cholesterol levels;
• resorption of blood clots;
• hormone regulation;
• slowing down the aging process.

Enzymes do not work alone; they need coenzymes to perform their tasks.

Digestive enzymes help break down food into components that can be absorbed, transported and used by every cell in the body. Digestive enzymes are extracellular, i.e. they are outside the cells. Most of these enzymes are produced in the pancreas.

There are 8 main digestive enzymes:

1. Protease - breaks down proteins.
2. Amylase - breaks down carbohydrates.
3. Lipase - breaks down fats.
4. Cellulase - breaks down fibers (fiber).
5. Maltase - converts complex sugars into glucose.
6. Lactase - breaks down lactose.
7. Phytase - helps digestion in general, especially in the production of B vitamins.
8. Sucrase - breaks down sugars.

The digestive process begins in the mouth. It is in the mouth that enzymes (mainly amylase) begin to act. Amylase contained in saliva begins to break down carbohydrates. When food enters the stomach, the protease works to break down proteins. After food enters the small intestine, lipase breaks down fats, and amylase finally cracks down on carbohydrates. It is in the small intestine that 90% of the digestive process and the absorption of nutrients that enter the bloodstream are assisted by the millions of tiny villi in the small intestine.

What is the danger of a lack of digestive enzymes and how to make up for it

When enough digestive enzymes are produced, they work together and provide an effective digestive process. In the case of a lack of enzymes in the digestive system, a number of problems arise.

The body's ability to produce enzymes is reduced if a person consumes a lot of processed foods, sweets, and frequently takes medications such as antibiotics.

Despite relatively big sizes enzymes, their protein structures are quite fragile. Amino acids in the molecular chain are combined with each other, forming certain sequences and forms that provide unique characteristics and enzyme functions. If the chain structure is broken, the enzyme becomes denatured - its shape changes, and the ability to perform functions disappears.

Enzymes are sensitive to high temperatures and changes in pH levels, which is why each enzyme works in a specific part of the digestive tract in accordance with the pH level necessary for its functioning. The number of enzymes produced decreases with age: by 13% every 10 years.

Deficiency of digestive enzymes leads to impaired digestion of food and absorption of nutrients, which leads to the following symptoms:

• constipation;
• bloating;
• stomach ache;
• flatulence and belching;
• heartburn and acid reflux.

Chronic malabsorption of nutrients can lead to the development of a number of diseases, since the body will not receive enough material to maintain health and fight disease.

In addition to breaking down food, enzymes (particularly proteases) promote intestinal healing, help control pathogens, and maintain immune system which originates in the intestines.

The immune system originates in the gut.

There are 4 ways to optimize the production of enzymes in the body, namely:

1. Eating raw (unprocessed) food. Raw foods are rich in enzymes, which, after heat treatment, lose their ability to perform their functions. Therefore, the more raw foods You eat the better. Ideally, a person should get 75% of their digestive enzymes from food.
2. Thorough chewing of food. The digestive process begins with chewing, as a result of which the absorbed food is easier to digest in the stomach and intestines. It should be noted that chewing chewing gum and chewing food are not the same thing. In the latter case, the brain causes the pancreas to double its production of enzymes when there is actually nothing to break down, so the pancreas is wasted.
3. Reducing the number of calories consumed. More "live", unprocessed food and fewer calories - means less energy expenditure on the digestive process and less need for the production of enzymes.
4. Avoid stress. Chronic stress adversely affects the functioning of the entire body, including its ability to effectively digest food and produce enzymes.

There are also special nutritional supplements that compensate for the deficiency of digestive enzymes. However, the site strongly recommends that you check with your doctor before taking any supplements to make sure you need to take them. Help the body work natural ways: by adjusting the diet, physical activity, rejection bad habits and stress control.