In patients with pancreatic exocrine insufficiency due to chronic pancreatitis, when there is strong acid inhibition with 60 mg Omeprazole, low dosages of pancreatic enzymes administered orally can be therapeutically efficacious for lowering symptoms and improving fat absorption.

A randomized double-blind two-way cross-over study compared the effects of two distinct doses of enteric-coated pancreatic enzyme preparation on abdominal symptoms and fecal fat excretion in people with exocrine insufficiency caused by chronic pancreatitis during strong acid inhibition by Omeprazole.

A total of 16 subjects with chronic pancreatitis (13 males and 3 females; age 53+3 years) were enrolled. During a 2-week control period, during Omeprazole 60 mg + pancreatic enzymes at 10,000 Fédération Internationale Pharmaceutique (FIP) International Units (IU) lipase three times a day (treatment A) for two weeks, and during Omeprazole 60 mg + pancreatic enzymes at 20,000 FIP IU lipase three times a day (treatment B) for 2-weeks, the abdominal symptoms (visual analogue scales [VAS]) were scored and measurement of fat intake and fecal fat excretion was done.

Fecal fat excretion was considerably lower during acid suppression using enzyme use contrasted to control: 18±7 and 18±5 g/24 hours vs. 36±8 g/24 hours for treatments A, B, and control, respectively. The overall health and abdominal symptom score were considerably enhanced following treatments A and B as opposed to control. There were no changes between treatments A and B in terms of symptom scores or fat excretion.

Treatment with lower than standard doses of pancreatic enzyme supplementation is useful with regard to reducing symptoms and boosting fat absorption during strong acid suppression in chronic pancreatitis-affected people.