RESUMO
Malabsorption of pancreatic origin has been traditionally treated with pancreatic enzymes, but the effectiveness of treatment has been limited, related to the scant enzymatic activity of preparations, enzyme lability to acid attack and deficient mixing with the intestinal bolus, among other factors. We studied the efficacy of a new pancreatic enzyme preparation in the form of pellets, which mix easily with the intestinal bolus, are protected against gastric acid attack and have a high lipase concentration (Creon, Kalichemie-Pharma), as compared to traditional unprotected pancreatin in the form of tablets (Pankreon 700). The study was open, comparative and crossover, and included 12 patients. The diagnosis was chronic alcoholic pancreatitis in 10 cases and idiopathic pancreatitis in 2, with a steatorrhea of more than 10 g/24 h and a basal gastric pH less than 2.5. The duration of treatment was 3 weeks, using a diet containing 100 g of fat. The first week served as a control, and in the 2nd and 3rd treatment was given in the form of 7 capsules of Creon (2.1 g pancreatin and 70,000 UFIP lipase) or 17 tablets of Pankreon 700 (11.9 g pancreatin and 476,000 UFIP lipase) by randomized assignment. Our results confirm the beneficial effects observed by others. Steatorrhea was significantly reduced, up to 45.6% with Pankreon 700 and 57% with Creon, in spite of a dose that had 6.8 times less lipase activity, 5.6 times less pancreatin weight and 2.4 times fewer units ingested (capsules/tablets). Patients showed significant weight gain. At 30 days of treatment with Creon, steatorrhea had declined 70% and the weight gain was significant.(ABSTRACT TRUNCATED AT 250 WORDS)