Question

Pancreatic Enzyme Supplements Are Not Effective for Relieving Abdominal Pain in Patients with Chronic Pancreatitis: Meta-Analysis and Systematic Review of Randomized Controlled Trials.

Answer 1

Despite minimal evidence of effectiveness, pancreatic enzyme supplementation is frequently used to relieve pain in people with chronic pancreatitis.

Comparing pancreatic enzyme supplementation to placebo, no improvement in discomfort was seen. The only trial that used enzymes without an enteric coating did indicate a decrease in pain score. In both analyses, there was a significant amount of study heterogeneity. A random model meta-analysis of three studies found no evidence of a difference between the periods of administering pancreatic enzyme supplementation versus placebo in the mean daily pain score (mean difference: 0.09 (1.57-1.39), p=0.91) or average weekly analgesic consumption (mean difference: 0.30 (2.37-1.77), p=0.77). Given their high cost and probable adverse effects, pancreatic enzyme supplements shouldn't be recommended only for treating abdominal pain in people with chronic pancreatitis.

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