Pancreatic Enzymes (Pancrelipase) : Bloating and Intestinal Gas
A エビデンス 複数の大規模臨床試験が一貫して有意な効果を示しています。Standard of care for exocrine pancreatic insufficiency. Pancreatic enzyme replacement therapy (25,000-40,000 lipase units/meal) normalizes fat absorption and helps resolve steatorrhea. FDA-approved medications (Creon, Zenpep).
結論
Standard of care for exocrine pancreatic insufficiency. Pancreatic enzyme replacement therapy (25,000-40,000 lipase units/meal) normalizes fat absorption and helps resolve steatorrhea. FDA-approved medications (Creon, Zenpep).
Key Study Findings
対象集団: Adults with pancreatic cancer (borderline/locally advanced/metastatic)
対象集団: 28-year-old woman with severe depression
対象集団: Patients with pancreatic cancer and EPI
対象集団: None
対象集団: Patients with exocrine pancreatic insufficiency
対象集団: children
Key Statistics
12
研究数
800
参加者数
Positive
グレード
Referenced Papers
Dosage & Usage
mg = milligrams · mcg = micrograms (1,000× smaller) · IU = International Units
一般的な使用量
- general:
- 25,000-40,000 lipase units per meal
- epiadults:
- 25,000-50,000 lipase units with meals, 10,000-25,000 with snacks
- epipediatric:
- 500-2,500 lipase units/kg/meal (max 10,000 units/kg/day)
上限量: 10,000 lipase units/kg/day (higher doses associated with fibrosing colonopathy)
研究で検討された用量
| 用量 | 期間 | 効果 | N |
|---|---|---|---|
| None | 26 weeks | Mixed | -- |
| 20 mg once daily | -- | Negative | 1 |
| Pancreatic enzyme replacement therapy (PERT) | -- | Positive | -- |
| None | -- | Mixed | -- |
| PERT (pancreatic enzyme replacement) | -- | Positive | -- |
| None | 26.0 weeks | Mixed | 35 |
| 16 g | 8.7 weeks | Mixed | -- |
| None | 52.0 weeks | Mixed | 20 |
推奨摂取タイミング: With meals and snacks; take half the dose at the beginning and half during the meal
Safety & Side Effects
報告されている副作用
- ⚠ Abdominal pain and cramping
- ⚠ Nausea
- ⚠ Fibrosing colonopathy at very high doses (rare; primarily in cystic fibrosis patients)
- ⚠ Hyperuricemia (high doses of protease can increase uric acid)
既知の相互作用
- ● Calcium carbonate and magnesium hydroxide antacids (may reduce enzyme activity)
- ● Acarbose and miglitol (pancreatic amylase may counteract alpha-glucosidase inhibitors)
- ● Iron supplements (protease may reduce iron absorption)
- ● Proton pump inhibitors (may improve enzyme efficacy by reducing acid denaturation)
耐容上限摂取量: 10,000 lipase units/kg/day (higher doses associated with fibrosing colonopathy)
サプリメントの摂取を開始する前に、必ず医療専門家にご相談ください。
Frequently Asked Questions
Does Pancreatic Enzymes (Pancrelipase) help with Bloating and Intestinal Gas?
How much Pancreatic Enzymes (Pancrelipase) should I take for Bloating and Intestinal Gas?
Are there side effects of Pancreatic Enzymes (Pancrelipase)?
How strong is the evidence for Pancreatic Enzymes (Pancrelipase) and Bloating and Intestinal Gas?
Related Evidence
に関する他の成分: Bloating and Intestinal Gas
References
- [1] Emma McShane et al.. Nutr J. 2025. Assessing the impact of an intensive dietitian-led telehealth intervention focusing on nutritional adequacy, symptom control and optional supplemental jejunal feeding, … doi:10.1186/s12937-025-01113-9 PubMed
- [2] Yangpeng Wu et al.. Front Med (Lausanne). 2025. Case Report: A case of drug-induced pancreatitis caused by paroxetine with a literature review. doi:10.3389/fmed.2025.1688065 PubMed
- [3] Mary Acelle G Garcia et al.. Pharmacy (Basel). 2024. Rational Prescribing of Pancreatic Enzymes for Patients with Pancreatic Cancer. doi:10.3390/pharmacy12020047 PubMed
- [4] David C Whitcomb et al.. Gastroenterology. 2023. AGA Clinical Practice Update on the Epidemiology, Evaluation, and Management of Exocrine Pancreatic Insufficiency: Expert Review. doi:10.1053/j.gastro.2023.07.007 PubMed
- [5] Nabi Nadia et al.. Cureus. 2023. An Infected Intrahepatic Pancreatic Pseudocyst and Calcified Pancreas: A Rare Complication of Chronic Pancreatitis. doi:10.7759/cureus.35384 PubMed
- [6] Puanani Hopson et al.. J Pediatr Gastroenterol Nutr. 2019. Isolated Amylase Deficiency in Children and Its Clinical Implication. doi:10.1097/MPG.0000000000002317 PubMed
- [7] Anabelle Cloutier et al.. Surg Obes Relat Dis. 2018. Long alimentary limb duodenal switch (LADS): a short-term prospective randomized trial. doi:10.1016/j.soard.2017.08.028 PubMed
- [8] Yalda Zolghadri et al.. Am J Pathol. 2018. Malnutrition in Pancreatic Ductal Adenocarcinoma (PDA): Dietary Pancreatic Enzymes Improve Short-Term Health but Stimulate Tumor Growth. doi:10.1016/j.ajpath.2017.11.014 PubMed
- [9] Mehrdad Nikfarjam et al.. Med J Aust. 2017. Diagnosis and management of pancreatic exocrine insufficiency. doi:10.5694/mja16.00851 PubMed
- [10] Colin D Johnson et al.. Patient. 2017. Qualitative Assessment of the Symptoms and Impact of Pancreatic Exocrine Insufficiency (PEI) to Inform the Development of a Patient-Reported Outcome … doi:10.1007/s40271-017-0233-0 PubMed
- [11] Jennifer Straatman et al.. Dig Surg. 2017. Systematic Review of Exocrine Pancreatic Insufficiency after Gastrectomy for Cancer. doi:10.1159/000454958 PubMed
- [12] Samer Alkaade et al.. Am J Manag Care. 2017. A primer on exocrine pancreatic insufficiency, fat malabsorption, and fatty acid abnormalities. PubMed
- [13] Carla Mancilla A et al.. Rev Med Chil. 2008. [Small intestine bacterial overgrowth in patients with chronic pancreatitis]. PubMed
- [14] F Suarez et al.. Dig Dis Sci. 1999. Pancreatic supplements reduce symptomatic response of healthy subjects to a high fat meal. doi:10.1023/a:1026675012864 PubMed
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