In the course of chronic pancreatitis, exocrine insufficiency with steatorrhea is a major clinical problem, which becomes overt after destruction of more than 90% of the gland. In patients with exocrine insufficiency due to chronic pancreatitis, pancreatic enzyme replacement therapy reduces maldigestion, prevents weight loss, and improves abdominal symptoms such as diarrhoea and gas bloating. A prospective, randomized, placebo-controlled, double-blind, crossover, and multicentre in design study was conducted to prove on a lipase-per-lipase basis the equivalence of pancreatin mini microspheres (Creon 10,.000 minimicrospheres) and pancreatin microspheres (Creon10,.000 microspheres). 37 patients entered the run-in period and during the entire study, patients took four capsules of identical appearance, each containing 10.000 Ph. Eur. units lipase, during every meal and two capsules with every snack. Pancreatin mini microspheres and microspheres were equally effective in improving the coefficient of fat absorption (CFA) inpatients with exocrine insufficiency due to chronic pancreatitis. Both preparations were well tolerated, and mild adverse events were similar in both treatment groups (4). Short-term benefit of 8 weeks pancreatic enzyme supplementation has been shown to improve the absorption of dietary fat, protein, and total energy and nitrogen balance in patients receiving local resection longitudinal pancreaticojejunostomy (LR-LPJ) for chronic pancreatitis. Supplementing the diets of 11 patients with pancreatin at doses that were individualized according to the initial measurement of fecal fat excretion significantly increased the mean coefficients of absorption of dietary fat and energy during the first 4 weeks of study. Following randomization to pancreatin or placebo, continued enzyme supplementation sustained a significant improvement in protein absorption, whereas placebo substitution worsened the absorption of fat and total energy to levels lower than baseline. Improved protein absorption accounted for the significantly positive effect of pancreatin supplementation on mean nitrogen balance. Each capsule contained 8,000 USP U of lipase,13,000 USP U of protease, and 30,000 USP U of amylase in enteric-coated microspheres and mini microspheres (5).
The inflammatory response is a predictable phenomenon that ensues musculoskeletal injury. While this response is a necessary component of the healing process, uncontrolled inflammation may prolong skeletal muscle recovery after intense exercise or training induced injury. Consequently, this type of muscle injury may delay return to normal function. Previous research has suggested that oral supplementation of protease may shorten recovery time after injury. It is believed that this is accomplished through early inhibition of the arachidonic cascade resulting in accelerated healing. Twenty healthy males (10 pairs) aged 18?29 years participated in a study to evaluate the effects of protease supplementation on muscle soreness and contractile performance after downhill running. Each pair consisted of individuals matched for age, height and weight. One member of each pair was randomly assigned to a treatment group receiving protease supplementation(n = 10), while their matched counterpart received a placebo (n = 10). All participants in the experimental group received protease supplementation over a 4-day period. During this period, they consumed two protease capsules four times a day. Each capsule contained 325 mg pancreatic enzymes,75 mg trypsin, 50 mg papain, 50 mg bromelain, 10 mg amylase, 10 mg lipase, 10 mg lysozyme and 2 mg chymotrypisn. The results of the study suggest that protease supplementation hastens recovery of contractile capabilities and attenuates
increases in perception of pain after downhill running (8). Another study determined the effectiveness of protease supplementation in attenuating eccentric exercise-induced skeletal muscle damage and inflammation. Subjects were randomly assigned to consume 5.83 g daily of either a cellulose placebo (N = 15) or a proteolytic supplement containing fungal proteases, bromelain, and papain for a period of 21 d. Significant group differences and another strong trend were observed for flexion indicating higher force production in the protease group. Significant group ? time interactions were observed, including elevations in circulating eosinophils and basophils in the protease group coinciding with lower levels of serum cyclooxygenase 2, interleukin 6, and interleukin 12 in this group. Protease supplementation seems to attenuate muscle strength losses after eccentric exercise by regulating leukocyte activity and inflammation (9).
Digestive aid. Helps to decrease bloating after high caloric, high fat meals. Digestive aid to help decrease bloating after high caloric, high fat meals. Dosages: 5000 - 40000 USP units of lipase activity per day, 16600 - 14940 USP units of amylase activity per day and 15625 - 150000 USP units of protease activity per day (10).
Betaine (glycine betaine or N, N, N-trimethylglycine), which is a significant component of many foods including wheat, spinach, beets, and shellfish, is obtained from the diet or from its metabolic precursor choline. Some of the physiological functions attributed to betaine include acting as an osmoprotectant. That is, it protects the cell against dehydration by acting as an osmolyte thereby increasing the water retention of cells. Other studies have indicated that betaine supplementation may lower plasma homocysteine concentrations and reduce inflammation(12). Betaine is a major tissue osmolyte and plays an important role in the metabolism of homocysteine, with betaine homocysteine methyltransferase (BHMT) catalyzing the remethylation of homocysteine to methionine. Plasma betaine is a determinant of total plasma homocysteine concentrations in patients with vascular disease under postmethionine load (PML) as well as fasting conditions. In a randomized crossover study, the acute effects of dietary and supplementary betaine and choline on plasma betaine and homocysteine under standard conditions and after a methionine load were compared. 8 healthy men consumed a betaine supplement (?500 mg), high-betaine meal (?517 mg), choline supplement (500 mg), high-choline meal (?564 mg), high-betaine and -choline meal (?517 mg betaine, ?622 mg choline), or a low-betaine and -choline control meal under standardconditions or postmethionine load. Plasma betaine, dimethylglycine, and homocysteine concentrations were measured hourly for 8 hand at 24 h after treatment. In conclusion, an acute physiologic dose of betaine, or its metabolic precursor choline, significantly increases plasma betaine concentrations in healthy volunteers under standard and PML conditions. Ingestion of a meal rich in betaine or choline, but not oral supplementation at a comparable level, led to a small reduction in plasma homocysteine under standard conditions, whereas dietary betaine and choline or a betaine supplement attenuated the rise in homocysteine after a methionine load. This study suggests that tissue betaine can be replenished by dietary betaine, and this also acts as a homocysteine-lowering agent (13). In addition, betaine also acts as a methyl donor by providing a methyl group to guanidinoacetate via methionine that can synthesize creatine in skeletal muscle. A study examined the efficacy of 15 days of betaine supplementation on muscle endurance, power performance and rate of fatigue in 24 active college aged men. Subjects consumed either the supplement (1.25 g of betaine mixed in 240 ml of a sport drink) or placebo (sports drink only) twice per day. The betaine for the supplement was extracted from sugar beet molasses. Two-weeks of betaine supplementation to inactive, college males appeared to improve muscle endurance of the squat exercise, and increase the quality of repetitions performed (14).
Digestive enzymes formula in tablets
- Support optimal digestion and proper absorption of nutrients (1),(2) .
- One tablet, once a day with each meal ensure patient compliance
Digest Plus provides a complete, well-balanced formula with natural enzymes and hydrochloric acid designed to enhance the digestion of proteins, fats and carbohydrates.
Sodium: 5 mg
Calcium: 90 mg
Betaine Hydrochloride: 162.5 mg
L-Glutamic Acid: 162.5 mg
Pancreatin 4X (from porcine pancreas): 65 mg
Papain (from Carica papaya fruit): 65 mg
Pepsin (from porcine stomach): 25 mg
Adults: Take one tablet with each meal or as recommended by your healthcare practitioner.
If you have an ulcer or acid reflux, consult your healthcare practitioner prior to use.
Dibasic calcium phosphate dihydrate, cellulose, silica, croscarmellose sodium, magnesium stearate, natural vanilla flavor, hypromellose, glycerin
Safety-sealed for your protection and for product freshness. Do not use if outer seal is missing or broken. Store in a cool, dry place.