Hi everyone

JS responded to one of our newsletter articles (written by our good friend June Henry) in relation to the effect of enzymes on pancreatic function.  Specifically, JS asks for any evidence of this.  Essentially, June was writing from personal experience and the common practice observed from medical practitioners.  June mentioned the following relating to this issue:

In this case, taking enzymes can be temporary, however it

> is not unusual for a person who has a functional, but permanently

> damaged pancreas to take enzymes for the rest of his life too. But

> my impression is that the need arises from the damage that was done

> prior to the start of enzyme therapy, not as a result of any long

> term suppression caused by the supplementation itself. (Of course,

> as the reader pointed out, supplements can also decrease symptoms

> of maldigestion in this sub-type of pancreatitis).

> 

> So the answer to his question is that yes, supplemental enzymes are

> thought to decrease the amount of enzymes that a pancreas will

> produce and secrete.  However, I do not know if this is a long

> lasting effect; my impression is that it suppresses the production

> and release of natural enzymes only for as long as they sit in the

> gut.  I do not know of any cumulative or long term suppression in

> relation to pancreatic enzymes but it sounds possible based on

> other drug / body interactions (many medications require tapering

> rather that quitting cold turkey).

> 

> In the situation described by the reader, his/her discomfort after

> discontinuing the enzyme supplementation could be caused by many

> things. But I am speculating that the pancreas may not be able to

> make adequate amounts of enzymes any more based more on the disease

> itself rather than as a result of taking supplements.

JS responded with the following:

Below you have written an excellent summary on details of a complex question “do supplemental enzymes decrease the amount of enzymes that a pancreas will produce or secrete?”

You said “yes” in your answer below.  Is this based on a study?  What evidence have you read or located to support such a statement?  Please email me back any information you can.

I have asked one gastroenterologist about this.  He disagrees but has no data to support his statement either.  I am checking with the chief gastro-surgeon at Moffitt but getting an answer back will take time because those folks stay busy.

I have had a Whipple, and these enzyme pills seem to help digestion.  My gastro-doc  has doubled the pills when I got pancreatitis shown by CT. The tradtional pain lasted for 4-5 days.  There has been no more attacks since

the double dossage.   However, if these pills are weakening, what remaining

pancreas I have to produce these enzymes, doubling enzymes doesn’t seem like such a good idea.

You can see why my request for a reference to support your statement would be extremely helpful.

If anyone has any comments please let us know.  I’m sure there will be more discussion on this issue as time goes on.

All the best

Jenny and Bill