Pancreatic Enzymes in Health and Disease
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Pancreatic Enzymes in Health and Disease With 55 Figures and 36 Tables
Springer-Verlag Berlin Heidelberg New York London Paris Tokyo Hong Kong Barcelona Budapest
Prof. Dr. Paul Georg Lankisch Department of Internal Medicine, Municipal Hospital Liineburg, Bogelstr. 1, W-2120 Liineburg, FRG
Library of Congress Cataloging-in-Publication Data Pancreatic enzymes in health and disease / Paul G. Lankisch (ed.). p. cm. ISBN-13: 978-3-540-53187-6
e-ISBN-13: 978-3-642-76097-6
DOl: 10.1007/978-3-642-76097-6 1. Pancreatitis-Chemotherapy. 2. Digestive enzymes-Therapeutic use. 3. Digestive enzymes. I. Lankisch, Paul Georg. [DNLM: 1. Pancreas enzymology. 2. Pancreatin therapeutic use. 3. Pancreatitis-drug therapy. WI 805 P1875j RC858.P35P33 1991 616.3'7-dc20 DNLMIDLC 91-4734 This work is subject to copyright. All rights are reserved, whether the whole or part ofthe material is concerned, specifically the rights oftranslation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in other ways, and storage in data banks. Duplication of this publication or parts thereof is only permitted under the provisions of the German Copyright Law of September 9, 1965, in its current version, and a copyright fee must always be paid. Violations fall under the prosecution act of the German Copyright Law.
© Springer-Verlag Berlin Heidelberg 1991 The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product Liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in the book. In every individual case the respective user must check its accuracy by consulting other pharmaceuticalliterature. Typesetting: Best-set Typesetter Ltd., Hong Kong 2113130-543210. Printed on acid-free paper
Dedicated to my family for their loving support
Preface
It has long been known that pancreatic enzymes are important
for digestion and that pancreatic enzyme substitution is necessary in pancreatic insufficiency. Upon closer scrutiny, however, we can detect a number of areas of uncharted territory on the map of "pancreatic enzymes in health and disease." These uncharted areas mainly concern the role that the enzymes play in the different phases of digestion, and especially the fate of these enzymes in the gastrointestinal tract and the effects that alcohol and different nutritional components exert on pancreatic function. Also in uncharted territory is how chronic pancreatitis affects gastrointestinal motility, other organs of the upper gastrointestinal tract, and the relationship between the exocrine and endocrine pancreas. These gaps mean that our knowledge of how to treat chronic pancreatitis is still unclear in some regards. Should pancreatic enzymes be used for pain treatment? How and in what form should pancreatic enzyme preparations be used for exocrine pancreatic insufficienc
