Creon

Question

How Does Creon© work?

Answer

The active parts of Creon© are pancreatic enzymes called amylase, lipase and protease.

Enzymes are proteins in the body with a specific task. Pancreatic enzymes are produced by the pancreas and released in the intestines were they help digest different nutrients.
Lipases play an essential role in the digestions, transport and processing of dietary lipids. Proteases has this function for proteins, amylase and cellulase have this function for carbohydrates.

The pancreatic ducts, used to transport enzymes to the intestines, are blocked due to thickened secretions in 90% of patients with CF and although the enzymes are produced by the pancreas, they never reach the duodenum sufficiently. For this reason, foods will not be processed or digested properly and uptake of nutrients into the blood is reduced or inadequate. Undigested foods end up in patients’ faeces.
Digestion of fats is most strongly affected in patients with CF.
Healthy persons take up more than 93% of fat from the food they eat in the duodenum. For patients with CF most of the fat (40% or more) ends up undigested in the large intestines making stools fatty.
Protein digestion is also affected, be it to a less extent than fat digestions. Undigested proteins are ‘digested’ by bacteria in the large intestines, but the wall of the large intestine cannot transport nutrients into the blood. Proteins contain nitrogen causing the typical smelly stools of patients with CF who do not or insufficiently take pancreatic enzymes with their meals.

Because food uptake is insufficient, there is a risk of malnutrition.
To improve digestions it is important to take pancreatic enzymes with meals. The pancreatic enzymes capsules will pass through the stomach and enter the duodenum where they digest the food, making it possible to uptake important nutrients in the blood. Pancreatic enzymes are produced from the pancreas of cows of pigs, although nowadays enzymes can be produced from small organisms using biotechnology. Pancreatic enzymes are available in different brand names, tables, capsules or granules (powder). Different brands differ in constitutions. One brand will contain more enzymes to process fat, others to process proteins or carbohydrates. The product you are referring to contains enzymes obtained from the pancreas of pigs.

The granules and tables are covered by an acid protective layer, which makes sure that the pancreatic enzymes do not dissolve in the stomach, but become active only in the duodenum. It is important that patients do not chew the granules or tables, because that will damage the protective shield. It is allowed to open the capsules to take in the granules by themselves, but this should be done immediately and with a small amount of water.
Mixing them with for example yoghourt will reduce the effectiveness of the enzymes.

Once in the intestines the enzymes are active for about half an hour, after which they are broken down. It is therefore important to spread intake of enzymes over the meals, especially for patients who eat slowly. Should one forget to take pancreatic enzymes during the meal it is possible to take the enzymes shortly after the meal, but not more than half an hour after the meal.
Dr. L. de Waele

05.10.2010