Probiotics for Pancreatic Enzyme Support
Probiotics may help small intestinal bacterial overgrowth that accompanies pancreatic disease, but do not replace enzymes.
Overview
Verdict
How It Works
Dosing & Protocol
Typical dose
- Recommended dose
- Strain-specific; discuss with a clinician in pancreatic disease
- Expected timeframe
- 4-8 weeks
Protocol
- form
- Not applicable. Pancreatic enzyme replacement therapy - pancreatin, prescribed as Creon or equivalent - is the treatment for exocrine pancreatic insufficiency, dosed in lipase units per meal
- duration
- Not applicable
- co factor
- Evidence is insufficient and the premise is mistaken. Probiotic bacteria produce some digestive enzymes of their own, which is the origin of the claim, but they do not stimulate pancreatic acinar secretion, do not replace pancreatic lipase, protease or amylase in the quantities required for digestion, and no trial has shown improvement in pancreatic function tests, faecal elastase, fat absorption or symptoms of exocrine pancreatic insufficiency. Trials of probiotics in acute pancreatitis have been conducted, and the largest - PROPATRIA - found significantly increased mortality in the probiotic arm, which is the most important finding in this area.
- titration
- Not applicable to probiotics. Enzyme replacement is titrated by a clinician, typically starting around 40,000-50,000 lipase units with meals
- starting dose
- Not established. Probiotics have not been shown to support pancreatic exocrine function at any dose
Evidence
What the studies say
Efficacy of a multi-strain probiotic on digestive symptoms and enzyme-related maldigestion: a randomized controlled trial
Ojetti V, Ianiro G, Tortora A +3 more
Probiotic supplementation reduced bloating and flatulence scores significantly versus placebo
Safety
Caveats
Avoid in severe acute pancreatitis and in critically ill or immunocompromised patients.
Less likely to help if
Medical Disclaimer
The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.
Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.