Pancreatic enzymes: what role do they play in the human body?

What are Digestive Enzymes?

The pancreas produces natural enzymes for digestion. They are involved in the breakdown of the main nutritional components: carbohydrates, proteins and fats. Pancreatic enzymes are substances that break down complex food components into simpler parts, which are then absorbed into the body's cells. As a result of the high specificity of the influence of enzymes, the organization and regulation of important processes in the body occurs. There are three groups of substances:

• Lipases are enzymes that break down fats. Produced by the pancreas, they are part of the gastric juice.
• Proteases - these enzymes break down protein and normalize the microflora of the gastrointestinal tract.
• Amylases are substances necessary for the processing of carbohydrates.

Pancreatic enzyme function

The largest gland in humans is the pancreas. If its operation is disrupted, it leads to the failure of many systems. The functional purpose of this organ is to carry out external and internal secretion, ensuring digestion. Without the enzymes produced by the gland, the human stomach cannot digest food properly, and nutrients become inactive and are poorly absorbed into the blood.

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Digestive enzymes produced by the pancreas

Due to the high specificity of the effects of enzymes, the fine organization of important life processes in the body is carried out. Digestive enzymes are highly active, they break down a wide variety of organic substances, which promotes good digestion of food. A list of all the main enzymes and their participation in the digestion process is presented in the table:

Proteolytic

Proteolytic enzymes, important for digestion, break peptide bonds in protein molecules and break down molecular products. As we age, less and less of these enzymes are produced. In addition, their synthesis is adversely affected by external factors and infections. Therefore, these substances may sometimes be in short supply. If the intestines are low in proteolytic enzymes, proteins will not be able to be digested quickly.

Lipase

The enzyme lipase, synthesized by the human body, catalyzes the hydrolysis of insoluble esters and promotes the dissolution of neutral fats. Together with bile, this enzyme stimulates the digestion of fatty acids and plant vitamins E, D, A, K, modifying them into energy. In addition, lipase is involved in the absorption of polyunsaturated acids and vitamins. The most important enzyme, thanks to which the complete processing of lipids is carried out, is considered to be pancreatic lipase, which breaks down fats emulsified by liver bile.

Amylase

The term amylase refers to a whole group of enzymes. There are three types of substances: gamma, alpha, beta. Alpha amylase (the name is of Greek origin) has a special meaning for the body. It is a substance that breaks down complex carbohydrates. A high concentration of this enzyme is observed in the pancreas, a low concentration in the salivary gland.

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Enzyme analysis

There are special tests that can determine the enzyme activity of the pancreas. The enzyme agent studied is lipase, amylase, which can be found in serum, urine or blood, less often they can be found in pleural fluid. The most common enzyme test is the diagnosis of serum amylase. If amylase is more than 130, this indicates possible pancreatitis; a reading from 60 to 130 indicates problems with the pancreas. Exceeding the norm by 3 times indicates acute pancreatitis or intestinal perforation.

Using blood serum, a lipase test can be done; it is considered sensitive when it comes to damage to the pancreas. When the disease occurs, lipase increases by 90%. If this enzyme is not increased, and amylase is large, then you should think about another disease. Based on the results of a biochemical blood test, the doctor is able to make an accurate diagnosis and choose a treatment program. Blood tests are performed on an empty stomach. It is better to take the analysis in the morning, when enzyme indicators are more objective. In addition to donating blood, the following tests may be performed:

• Stool analysis.
• Special tests that stimulate the body with drugs and amino acids. Afterwards, the necessary enzymes are determined from the intestinal contents.
• Analysis of urine. Collect only in clean disposable containers.
• Blood serum analysis.

Drugs and therapy

As already mentioned, enzyme-acting drugs are prescribed for violations of the exocrine function of the pancreas. It is disrupted as a result of the development of pathological processes in the organ (necrosis, inflammation, etc.), against the background of which the integrity of the gland cells is damaged, and they cease to produce the enzymes necessary to maintain digestion.

Unfortunately, without them, food cannot be digested properly, which leads to serious health problems. The patient often experiences nausea, vomiting, decreased appetite, constipation, etc. At the same time, there is an increased content of fat and pieces of undigested food in the stool. But that's not the worst thing.

With pancreatitis (inflammation of the pancreas), frequent pain attacks may occur, associated with serious disturbances in the functioning of the gland. Due to severe inflammation, its parenchyma swells, which causes compression of the excretory ducts and narrowing of their lumen. This entails a violation of the release of pancreatic juice and its stagnation in the organ.

This phenomenon often occurs against the background of errors in nutrition or lack of taking enzyme preparations, which help relieve the load on the pancreas. But it is precisely excessive loads that provoke the occurrence of acute inflammation in it.

Medicines containing enzymes have been on the pharmaceutical market for many years. They are made from bovine or pork pancreas, which contains digestive enzymes identical to humans.

Before the production of medicines, the raw materials are processed by freeze-drying, as a result of which only the necessary parts of pancreatin, containing digestive enzymes, are obtained. Among them are:

• amylase, without which the breakdown of carbohydrates cannot occur;
• protease necessary for protein digestion;
• lipase responsible for the breakdown of fats.

Enzymes for digesting food

In pancreatitis and other diseases of this organ, these pancreatic enzymes are produced in insufficient quantities. And in order to prevent the occurrence of serious complications from the gastrointestinal tract, doctors use enzyme agents that replenish the deficiency of these substances in the body and improve the functioning of the digestive tract.

But, despite the fact that tablets containing pancreatin are safe for humans. Under no circumstances should they be taken without the knowledge of the attending physician. Firstly, they must be taken strictly according to the scheme, since their incorrect use can lead to serious disruptions to the gastrointestinal tract.

For babies

One type of deficiency of organic substances manifests itself in a disease called celiac disease.
Often infants are diagnosed with enzyme deficiency, which means intolerance to certain types of food. This type of complication is associated with the child’s lack of enzymes. There is no enzyme - the digestive tract is not able to function fully.

Lactose deficiency can occur in children in the first days of life. There is no need to give up breastfeeding; therapy consists of the mother following a diet. At the same time, the specialist prescribes lactase for mother and baby.

The second type of organic substance deficiency in children manifests itself in a disease called celiac disease. Most often, the question of deviation arises at six months of age (the period of introducing porridges). The basis of treatment is avoidance of foods containing gluten.

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What is pancreatic enzyme deficiency?

The pancreas, like any other organ, can fail. The most common disease is its deficiency. With an enzymatic deficiency of substances produced by the pancreas, a symptom of the disease becomes incomplete and difficult digestion, which entails metabolic disorders and the development of pathological conditions. The reasons for the deficiency may be:

• Food poisoning.
• Enzyme inhibitors.
• Lack of vitamins.
• Damage to pancreatic tissue.
• Poor nutrition. Eating salty and fatty foods.
• Decreased protein levels.
• Reduced hemoglobin.
• Bad heredity.

Diagnosis and symptoms of decreased exocrine function

Laboratory tests are performed to determine which enzymes the pancreas does not produce in sufficient quantities. Based on the results of blood, urine and feces tests, instrumental studies, as well as taking into account existing symptoms, enzyme preparations may be prescribed.

The enzyme content standards are as follows:

• blood: amylase – 29-99, lipase – 22-66, trypsin – 19.7 – 30.3 mg/l;
• blood serum: elastase – 01 – 4 ng/ml;
• urine: amylase (diastase) – max 100 units/l;
• coprogram: elastase – from 200 mcg/g.

Pancreatic enzymes are produced in the acinar cells of the pancreas, then through the smallest tubules they enter larger ducts that form the main duct - Wirsung

Deficiency of pancreatic enzymes leads to serious disorders of digestive function and the functioning of the body as a whole. In case of excessive production of enzymes, acute inflammation of the pancreas is diagnosed - pancreatitis. A decrease in enzyme synthesis means the disease becomes chronic.

The following reasons can lead to inflammatory-destructive changes in the pancreas and replacement of glandular tissue with fibrous tissue:

• overeating and abuse of fatty foods and alcoholic beverages;
• the presence of neoplasms - cysts, tumors (both benign and malignant), fibrosis;
• pathologies of the duodenum and biliary tract;
• surgical operations on the pancreas.

How to check the pancreas

• polyfecality (large volumes of excreted feces);
• mushy, liquid stools of a grayish color with a shiny, oily surface and an unpleasant odor;
• the presence of undigested food fragments in the stool;
• feeling of fullness in the stomach and nausea, heartburn;
• unpleasant taste in the mouth;
• decreased appetite;
• flatulence, churning in the stomach;
• weight loss, anemia, weakness, insomnia and headache;
• abdominal pain after eating;
• intolerance to fatty and spicy foods.

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Since the synthesis of lipase decreases first, stool disorder is one of the first to appear - it becomes viscous or semi-liquid. It is worth noting that the symptoms are almost the same both with an excess of enzymes and with a deficiency.

Violation of the exocrine function of the pancreas requires mandatory treatment, since it can lead to the development of such serious diseases as pancreatic necrosis, gastric ulcer, hepatitis and cirrhosis

There are several reasons that affect the normal functioning of this gland:

1. congenital diseases of this organ, its agnesia or hypoplasia;
2. diseases acquired during life, particularly acute and chronic pancreatitis.

The reasons why inflammation of the pancreas occurs, and, accordingly, the production of enzymes:

• alcohol abuse, as a result of which pancreatic cells begin to actively die and enzymes cease to be produced in sufficient quantities. Moreover, the disruption of production begins with literally a few sips of alcohol;
• smoking affects the functioning of this organ, causing pancreatitis;
• unbalanced diet. As mentioned above, constant consumption of the same products entails a disruption in the production of substances. Also, the functioning of the pancreas is affected by long periods of food intake, as a result of which insulin secretion decreases. And the lack of this enzyme leads to the appearance of diabetes;
• excessive consumption of animal fats. Fatty foods force this gland to work at an increased pace, which is why pancreatic juice becomes thicker than usual and its discharge is disrupted. At this moment, a person may feel discomfort in the stomach area.

You can’t call a dish very healthy or, conversely, very harmful. For stable functioning of the pancreas, it is necessary to adhere to a balanced diet; the diet should contain fats, proteins, carbohydrates, and sugars in equal proportions.

If pancreatic enzymes are secreted in insufficient quantities, the following symptoms appear:

1. a feeling of heaviness or bloating in the abdomen;
2. decreased feeling of hunger;
3. pain concentrated in the stomach area;
4. severe nausea after eating certain foods;
5. bowel dysfunction (constipation, diarrhea);
6. pronounced loss of strength.

If the above symptoms occur, you should immediately consult a competent doctor, undergo an examination and receive the necessary treatment.

When treating abnormalities in pancreatic secretion, two main methods are used. Firstly, a certain diet is followed: limited consumption of foods rich in animal fats, frequent meals in small quantities.