New enteric-coated high-lipase pancreatic extract in the treatment of pancreatic steatorrhea.

We studied a new enteric-coated pancreatic extract with very high lipase content in 12 patients with steatorrhea due to chronic pancreatitis. Fecal fat was measured under standard dietary conditions (100 g lipid/day) with no enzyme supplementation and during treatment with 75,000, 150,000, or 225,000 IU of lipase per day. The median fecal fat output (g/day) was significantly (p < 0.005) lower after each increase in dosage: basal, 20.5 (range, 10.3-92.2); 3 cps/day at meals, 13.3 (6.4-38.2); 6 cps/day, 9.9 (4.8-31.4); 9 cps/day, 7.3 (2.6-17.3). For the five patients with a basal fecal fat output of < 15 g/day, steatorrhea was totally corrected by 3 cps a day. Of the seven patients with more severe steatorrhea, the fecal fat output of only two was not normalized with the highest dose of 9 cps/day: for one it was reduced to 13.3 g/day from a basal of 92.2 g/day and for the other to 17.3 g/day from 25.4 g/day. This pilot study demonstrates that the tested pancreatic extract very effectively corrects pancreatic steatorrhea in a simple low-dose regimen. Good compliance can be expected.