[Replacement therapy with pancreatic enzymes and the principle of reversible regulation of the enzyme-secreting activity of the pancreas].

In patients suffering from chronic pancreatitis (outside exacerbation) with initial enzyme-secretory pancreatic failure, the two-week intake of pancreatin as a replacement therapy brought about a decrease of the enzyme-secretory activity of the patient's own pancreas paralleled by the lowering of diurnal steatorrhea. This was confirmed by repeated pancreozymine tests. These data confirm the concept of a reverse relation between pancreatic enzymatic secretion and the concentration of the enzymes in the duodenal contents. Combined administration of pancreatin and calcium gluconate led to the preservation of the degree of steatorrhea by the enzymatic preparation. At the same time its inhibitory effect on the activity of the own pancreas was prevented. The effect of calcium gluconate is accounted for from the standpoint of the role Ca2+ plays in the maintenance of the function of the exocrine part of the pancreas. The combination with calcium gluconate is indicated in the clinical use of replacement therapy with preparations of pancreatic enzymes in patients with chronic pancreatitis.