[Pancreatic enzyme replacement in mucoviscidosis (CF): clinical evaluation of a gastric acid-resistant pancreatin preparation in encapsulated microtablet form].

Pancreatic enzyme replacement therapy was tested in 17 patients with CF. Severe pancreatic insufficiency had been established by stool fat determination prior to therapy. Two enzyme preparations were tested that were equal in acid protection, but were different in the release of enzyme activities. Complaints, body weight, and stool frequency were not influenced by changing preparations. Stool weight and stool fat excretion did not show statistically significant differences, when the preparations were used in lipase equivalent doses. By using one of the preparations tested (Panzytrat 20,000), it was possible to reduce the number of capsules that had to be taken daily. Mild to moderate steatorrhoea was noted in spite of pancreatic enzyme replacement in all the CF patients. Massive steatorrhoea was seen in two patients with good nutritional status, due to high fat intake. It was proposed that moderate steatorrhoea may be tolerated in CF, as long as the nutritional status is adequate. If this is not the case, energy intake and, as a consequence, the dosage of pancreatic enzyme replacement therapy have to be raised.