Digestive enzymes

Digestive enzymes (or otherwise "enzymes") are the special connections participating in splitting of three basic nutritious elements: proteins, carbohydrates and fats.

Digestive enzymes began to be applied widely by fans of strength sports from the 1990th. At bodybuilding athletes, training according to intensive programs, they go literally in great demand. The secret of such popularity is simple: enzymes help the main nutrients to be acquired much quicker and more effectively. And for those who with a set of weight have "dietary" difficulties, enzymes - just a panacea.

Application

Some nutritionists offer special "shock" diets plans today for those who have difficulties with building-up of weight. Its essence is in daily to receive many exactly 2000 kilocalories a day and "to help" itself digestive enzymes. Theoretically the more you eat, the more nutritious elements acquire an organism. And the more it acquires, the more effectively there is a set of weight. Moreover, the research Buford TW of 2009 showed that digestive enzymes are capable to accelerate recovery and growth of muscles.

But whether it is always reasonable? Excess calories are always risk of fatty deposits. And digestive enzymes won't help here: they don't influence how calories in an organism are distributed. Receiving additional calories even if accompanied by enzymes, you gather not only the muscle bulk, but also fat.

Use of enzymes in bodybuilding will be reasonable in two cases: 1) in case of the digestion violation arising because of a digestive tract overload food 2) which with great difficulty gain weight.

Bases of digestion

Before resolving an issue of reception of enzymes, it is necessary to gain an elementary impression that it, actually, digestion. Digestion is the process referred on splitting the nutrition which came to an organism on chemical components. It allows nutrients to be soaked up in a blood, i.e. to be acquired and used for designated purpose. Splitting and an absorption are two components which are necessary in order that the basic nutritious elements (proteins, carbohydrates and fats), vitamins and minerals got from an intestine into a blood.

Having acquired these substances, the organism refers them to various tissues for ensuring body height, restoration, development of energy or just for deposition.

Digestive enzymes participate practically in each chemical reaction which happens in an organism, and act as catalysts of these reactions in all our life support systems. In the course of digestion enzymes are responsible for the reactions splitting long chains of alimentary molecules on simpler components. And these components then get into a blood through intestine walls.

Whether additional enzymes are necessary to you?

If you train adequately and restored, but progress is absent, then, obviously, the problem is covered in insufficient entering of calories. It is necessary to enlarge diet caloric content gradually. But only at the expense of qualitative products, following rules of a delivery. Continue to increase caloric content at least 2 weeks, and then begin to draw conclusions. If body height of force and weight still doesn't happen, check whether you have symptoms of shortage of digestive enzymes of a stomach:

• Unpleasant feelings in a stomach right after meal.
• Strong eructation after food.
• Feeling of "raspiraniye" in a stomach which proceeds long enough.
• Gastric disturbance after plentiful food.
• Gastric disturbance after several small meals.
• One more widespread type of disturbance of digestion - shortage of enzymes in a small intestine. Other symptoms are characteristic of it:
• "Swirling" and abdominal distention.
• Feeling of a dyscomfort in an abdominal cavity.
• Clump of gases
• Frequent diarrheas.
• Brightly painted, not properly executed or with a pungent smell a chair.
• Slime in a chair.

If upon transition to a diet with the increased caloric content you noticed emergence of the listed symptoms, it is quite probable that you should accept digestive enzymes. To find out it precisely, reduce caloric content to usual level and track that happens to your symptoms. If they disappeared - means, enzymes are really necessary for you.

At the same time consider that some of the listed symptoms can be caused not only by shortage of enzymes, but also some illnesses, food allergies, neurosises and hypersensibility. If you aren't sure of the reason - consult to the doctor.

The best fermental medicines

The optimum choice for elimination of the phenomena at a set of muscle bulk:

The medicines Amylase (digests carbohydrates) the Lipase (digests fat) Proteases (digest proteins)

Panzinorm forte 12000 PIECES 20000 PIECES 900 PIECES

Mezy forte 4200 PIECES 3500 PIECES 250 PIECES

Kreon of 8000 9000 PIECES 8000 PIECES 450 PIECES

Festal of 4500 PIECES 6000 PIECES 300 PIECES

Pancreatinum of 10 000, 20 000 or 25 000 PIECES of 9000, 18 000 or 22 500 PIECES 500, 1000 or 1250 PIECES

Composition of ferment drugs

At disturbance of digestion various medicines containing enzymes are applied. Depending on structure ferment drugs can be divided into several groups:

• Stomach mucosa extracts which main active ingredient is Pepsinum (abomin, atsidinpepsnํ).
• The pancreatic enzymes presented by an amylase, a lipase and Trypsinum (pansinorm forte-N, Pancreatinum, pan-Citras, mezim-forte, creon).
• The combined enzymes containing Pancreatinum in a combination with components of bile, gemitsellyulozy and other additional components (pansinorm forte, Digestalum, Festalum, enzistat).
• The vegetable enzymes presented by a papain, a fungic amylase, a protease, a lipase and other enzymes (pepfiz, Orazum).
• The combined enzymes containing Pancreatinum in combination with vegetable enzymes, vitamins (vobenzy).
• Disaccharidases (tilaktaza).

The first group of enzymes is generally referred on correction of secretory dysfunction of a stomach. Pepsinum which are contained in their structure, cathepsine, peptidases split practically all natural proteins. These drugs are used mainly at atrophic gastritis, they shouldn't be prescribed at the diseases proceeding against the background of the normal.

The drugs including pancreatic enzymes are used for correction of disturbances of process of digestion, and also for a regulation of functions of a pancreas. Traditionally the complex drugs containing the main enzymes of a pancreas of pets are for this purpose used (first of all a lipase, Trypsinum, chymotrypsin and an a-amylase). These enzymes provide a sufficient range of digestive activity and promote stopping of clinical signs of failure of a pancreas to which carry a loss of appetite, nausea, abdominal murmur, a meteorism, steato-, kreato-and an amylorrhea.

Drugs differ on activity of components that should be considered at their choice.

The amylase entering a complex decomposes Amylum and pectins to simple Saccharums – sucrose and maltoses. The amylase splits mainly extracellular polysaccharides (Amylum, a glycogen) and practically doesn't participate in hydrolysis of cellulose.

Proteases in fermental medicines are presented mainly by chymotrypsin and trypsin. The last along with proteolytic activity is capable to inactivate rileasing-factor therefore decrease the maintenance in blood and pancreatic secretion by the principle of feedback.

Besides, trypsin is the important factor regulating motility of a gut. It is carried out as a result of interaction with RAP-2-retseptorami of enterotsit.

The lipase participates in hydrolysis of neutral fat in a small intestine.

The combined medicines along with Pancreatinum contain bilious acids, gemitsellyulaza, simeticon, vegetable bile-expelling (turmeric), etc.

Introduction to medicine of bilious acids significantly changes his action to function of digestive glands and motility of digestive tract. The medicines containing bilious acids increase pancreatic secretion and kgolerez, stimulate motility of intestines and gall bladder. Bilious acids increase the osmotic pressure of intestinal contents. In the conditions of a microbic contamination of intestines that in certain cases promotes activation of tsAMF of enterotsit with the subsequent development of osmotic and diarrhea.

The combined medicines containing components of bile create optimum conditions for fast and full proteolysis, fats and carbohydrates in duodenal and lean guts. Medicines are appointed at insufficient function of a pancreas in combination with pathology of a liver, bile-excreting system, at violation of chewing function, an inactive way of life, short-term errors in food.

Existence in composition of the combined medicines along with enzymes of a pancreas of components of bile, pepsin and hydrochlorides of amino acids (panzinorm forte) provides normalization of processes of digestion at patients with gipoatsidny or anatsidny gastritis. At these patients functions of a pancreas, a bile production, as a rule, suffer.

P of some medicines (festat), promotes splitting of vegetable cellulose in a gleam of a small intestine, intestinal microflora normalization.

Many fermental medicines contain simetikon or dimetikon which reduce a superficial tension of bubbles of gas owing to what they break up and absorbed by walls of a stomach or intestines.

Fermental medicines of a phytogenesis contain papainase or fungal amylase, protease, a lipase (pepfiz, an oraza). Papainase and proteases are hydrolyzed by proteins, fungal amylase – carbohydrates, a lipase, respectively, – fats.

Except three above-stated groups there are small groups of the combined fermental medicines of a phytogenesis in combination with Pancreatinum, vitamins (vobenzy) and disakharidazam (tilaktaza).

The form of release of medicine is the important factor determining efficiency of treatment. The majority of fermental medicines are issued in the form of a dragee or tablets in the kishechnorastvorimykh covers that protects enzymes from release in a stomach and destructions by hydrochloric acid of gastric juice. The extent of the majority of tablets or dragee constitutes 5 mm and more. Nevertheless, it is known that from a stomach along with food firm particles which diameter constitutes no more than 2 mm can be evacuated. Larger particles, in particular fermental medicines in tablets or a dragee, are evacuated during the interdigestive period when food is absent in a duodenum. As a result medicines don't mix up with food and insufficiently actively participate in digestion processes.

For ensuring fast and homogeneous mixing of enzymes with a food himus fermental medicines of new generation in the form of microtablets (pan-citrate) and microspheres (๊๐ๅ๎ํ, a likreaza) which diameter doesn't exceed 2 mm were created. Medicines are covered with kishechnorastvorimy (enteric) covers and put into gelatin capsules. In case of hit in a stomach gelatin capsules are quickly dissolved, microtablets mix up with food and gradually arrive in a duodenum. In case of ๐อ duodenal content higher than 5,5 covers are dissolved, and enzymes begin to act on a big surface. At the same time physiological processes of digestion when pancreatic juice is emitted in the portions in response to periodic receipt of food from a stomach are practically reproduced. One of the Best Nooropic drug is Cerebrolysin.

Many fermental medicines contain simetikon or dimetikon which reduce a superficial tension of vials of gas owing to what they break up and absorbed by walls of a stomach or intestines.

The short pharmacological characteristic

Atsidin-pepsin – the medicine containing enzyme. Receive from a mucous membrane of a stomach of pigs. Tablets on 0,5 and 0,25 g contain 1 part of pepsin, 4 parts of an atsidin (a hydrochloride betaine). Are appointed in case of hypo - and on 0.5 g 3–4 times a day during food. Tablets dissolve previously in 1/2 glasses of water.

Vobenzim – the combined medicine containing highly active enzymes of a vegetable and animal origin. Except Pancreatinum contains papainase (from Carica Papaya plant), bromelain (from pineapple ordinary) and rutoside (group of vitamin P). Holds a specific place among fermental medicines as along with the expressed enzymatic properties possesses anti-inflammatory, antiedematous, fibrinolytic and secondary action. The range of application is very wide. The dose is established individually – from 5 to 10 dragees 3 times a day. The management on quality control of foodstuff and medicines of the USA prohibited to the distributor of medicine to declare its efficiency in case of any diseases as scientific data on its safety and efficiency are absent .

Digestal – contains Pancreatinum, extract of bile of cattle. Medicine is appointed on 1–2 dragees by 3 times a day in time or after food.

Kreon – medicine which gelatin capsule contains a large number of Pancreatinum in granules, steady against hydrochloric acid. Medicine is characterized by bystry (within 4–5 min.) dissolution of gelatin capsules in a stomach, release and uniform distribution of granules, steady against gastric juice, on all himus. Granules freely pass through a sphincter along with himusy in a duodenum, completely protect Pancreatinum enzymes in case of a passage through acidic environment of a stomach and are characterized by fast release of enzymes in case of intake of medicine in a duodenum.

Likreaza – fermental medicine on the basis of the extract received by crushing, is fresher than degreasing and drying or the refrigerated pancreas of a pig. Capsules contain the microspheres with a diameter of 1-1,2 mm containing Pancreatinum are stable and don't collapse in the environment of a stomach with ๐อ lower than 5,5. In case of the dispepsicheskikh frustration appoint 1–3 capsules a day, it is possible to increase a dosage to 6 capsules a day.

Mezim-forte – more often appoint for correction of short-term and insignificant dysfunctions of a pancreas. Dragees are mezim-forte covered with the special glaze cover protecting components of cure for aggressive impact of acidic environment of a stomach. Apply 1–3 dragees 3 times a day before food.

Merkenzim – the combined medicine which contains 400 mg of Pancreatinum, 75 Pieces of a bromelain and 30 mg of bull bile. Bromelaina represent the concentrated mix of the proteolytic enzymes extracted from fresh fruits of pineapple and its branches. Medicine two-layer. The outer layer is constituted by bromelaina which are released in a stomach and show proteolytic action. The inside layer is steady against hydrochloric acid of a stomach, arrives in a small intestine where Pancreatinum and bile are released. Bromelaina remain effective in a broad range ๐อ (3,0–8,0) therefore it is possible to appoint medicine irrespective of amount of hydrochloric acid in a stomach. Merkenzim is appointed on 1–2 tablets 3 times a day after food.

Panzinorm forte – medicine, consists of extract of a mucous membrane of a stomach, extract of bile, Pancreatinum, amino acids. Extract of a mucous membrane of a stomach contains pepsin and ๊เ๒ๅ๏๑่ํ with high proteolytic activity, and also peptides which promote release of a gastrin, the subsequent stimulation of glands of a stomach and release of hydrochloric acid. Panzinorm is two-layer medicine. The outer layer contains pepsin, ๊เ๒ๅ๏๑่ํ, amino acids. This layer is dissolved in a stomach. The inside layer is acid resisting, is dissolved in intestines, contains Pancreatinum and extract of bile. Panzinorm – one of the few medicines which along with replaceable possesses the action stimulating digestion that does it by preferable medicine in bodybuilding. Medicine is accepted on 1–2 dragees during food 3–4 times a day.

Pancreatinum – the medicine of a pancreas of cattle containing enzymes. The daily dose of Pancreatinum constitutes 5–10 g. Pancreatinum is accepted on 1 g of 3-6 times a day before food.

Pan-citrate – medicine of new generation with the high content of Pancreatinum. Has the pharmakodinamika similar with kreony. Gelatin capsules contain microtablets in a special enteric cover, resistant to gastric juice that guarantees release of all enzymes in intestines. Appoint on 1 capsule 3 times a day.

Tilaktaza – the digestive enzyme representing lactase which is in a brush border of a mucous membrane of a lean gut and proximal department of a podvzdoshny gut. Splits lactose on simple sugar. Appoint inside 250–500 mg before the use of milk or dairy products. Medicine can be added to the food containing lactose.

Festal, enzistat, panzistat – the combined fermental medicines containing the main components of a pancreas, bile and a gemitsellyulaza. Apply 1–3 dragees during food 3 times a day.

Digestive enzymes in additives (as a rule dosages are extremely underestimated)

• Betaine hydrochloride
• Bromelayn
• Papainase
• Bull bile (concentrate, extract, powder)
• Fungal amylase, protease, lipase (pepphis, oraza)

Highly active pancreatic enzymes

Representatives of pancreatic enzymes of rather new generation are medicines ๊๐ๅ๎ํ 10000, ๊๐ๅ๎ํ 25000 (Solvay Pharma) and pan-citrate 10000, pan-citrate 25000 (Knoll). Medicines contain the standardized Pancreatinum received from a pancreas of pigs.

The medicines containing pancreatic enzymes in the form of microgranules or microtablets can be applied as it is permanent as replacement therapy, and once in case of food loading.

The dose is selected individually, it depends on degree of expressiveness of clinical laboratory indicators of function of a pancreas. Judge sufficiency of a dose on clinical (normalization of frequency and nature of a chair) and to laboratory indicators (disappearance of a steatorea and kreatorea in to - the program, normalization of triglycerides in a chair lipidogramma).

Availability of microspherical medicines allows to increase considerably efficiency of treatment by enzymes.

Capsules should be swallowed entirely with enough water (100 ml). In case of difficulty of a proglatyvaniye of the capsule entirely it is opened and minimicrospheres mix with food, swallow without chewing!

Kreon it is necessary to appoint with any fat-containing food. The dose is selected individually, in need of it increased gradually. It is impossible to pound microtablets/microspheres to a powder consistence.

It is better to carry out therapy by enzymatic medicines differentially.

When matching enzymatic medicine it is necessary to be guided by the following criteria:

high doses of enzymes for replacement therapy;

low doses for treatment of functional changes of activity of a pancreas.

Treatment of pankreatopatiya requires purpose of small doses of Pancreatinum which in this case unloads a pancreas and at the same time stimulates development of bigger amount of enzymes by it.

Lack of effect of replacement therapy can be a consequence:

• wrong diagnosis (steatorea, consequence of violation of intestinal absorption, lyambioz, uncontrollable bacterial growth);
• violations of the mode of reception of medicine;
• insufficient amount of the accepted enzyme;
• losses of activity of enzyme in medicine;
• enzyme inactivation in stomach contents.
• The last factor attracts keen interest though the inactivation of pancreatic enzymes is known for gastric juice already many years.

Pancreatic lipase it is irreversible it is inactivated by gastric juice at pH 4,0 value below. The acid environment leads to secretion of large volumes of bile and pancreatic juice. By the last researches it is shown that with chronic pancreatitis gastric hyper secretion occurs at patients more often than it was supposed.

Receptions which doctors try to overcome an inactivation of enzymes gastric juice are well-known: increase in a dosage, reception of antatsid, antagonists of H2 receptors, inhibitors of the protonew pump.

Separately it would be desirable to stop on possible side effects of fermental therapy. Distinguish painful feelings in a mouth from them, irritation of skin in peri-anal area, discomfort in a stomach. Allergic reactions at patients with hypersensitivity to pork protein, and also violation of absorption of folic acid and iron at reception of high doses are described.

Since 1994 messages on development against the background of reception of a number of fermental medicines (pan-citrate) of a thick gut have appeared. It has forced doctors of the whole world to belong with care to again created highly active medicines and high doses of these medicines.

Side effects and complications

The wrong opinion is widespread in life and even among specialists that administration of drugs with digestive enzymes can lead to decrease in development of own enzymes. This opinion is supported with the universal rule of physiology: in an organism everything is regulated on a feedback mechanism. And if we artificially increase concentration of any endogenous substance, then on a feedback mechanism the organism tries to lower its products. Feedback in response to intake of exogenous enzymes really exists, however the long experience of use of enzymatic medicines showed that violation of own sekretorny function doesn't develop, it is possible to be convinced of it easily, having opened any modern textbook of pharmacology.

The Swedish research in 1998 didn't find any changes in development of enzymes by the person after 4 weeks of therapy by oral pancreatic enzymes. Other early research showed what the extract of a pancreas of pigs placed in a small intestine actually increased development of pancreatic enzymes, but if instead net trypsin (enzyme-protease) was used, reduction of pancreatic secretion was observed, but only in case of very high level of trypsin. In work of Walkowiak of 2003 (Eur J Clin Invest. 33:65, 2003) it is noted that pancreatic enzymes in high doses (5 g a day within 7 days) could reduce the pancreatic elastaza measured in a chair by 50%. This effect completely disappeared when acceptance of enzymes was stopped, and smaller doses didn't show influence on their secretion at all.

Side effects arise extremely seldom, from them the most probable are the intolerance and allergic reactions, and also a lock in case of improper feeding. More detailed data in the instruction.

Long acceptance of enzymes causes deficit of iron as reduces its absorbability.