G006: GUT TRANSIT TIMES AND FAT DIGESTION - A COMPARISON OF
STANDARD AND HIGH STRENGTH PANCREATIC ENZYMES
S. Seal, P. McClean, M. Green, S. P. Wolfe, M. Harding*,
W. A.. Coward* and J. M. Littlewood (Department of Paediatrics,
St. James University Hospital, Leeds and *'MRC Dunn Nutrition
Unit, Cambridge)
Reports of colonic strictures in children have suggested a possible link with high strength pancreatic enzymes (HSPE). This study aims to determine whether the relatively late release of HSPE activity results in unphysiological and inappropriately high enzyme levels in the colon compared to standard strength preparations.
Maximal lipolytic activity (l3C breath tests) and transit times (hydrogen breath tests, carmine red marker) were compared with standard and high strength pancreatic enzymes.
Results of 12 studies on the first 4 patients are available. A similar delay in lipolysis occurred with both HSPE and standard preparations. The median oro-caecal transit time and time to peak 13C recovery were both prolonged at 6.5 hours (range 4-7) and 4 hours (3.5-7.5) respectively and not influenced by the type of enzyme. For each child the relation of time to peak 13C recovery and oro-caecai transit time was consistent and independent of the type of enzyme. A second peak of 13C recovery was noted at 8-12 hours in all children who continued the test beyond 7.5 hours.
The lipolytic activity of HSPE and the standard; preparations are similar in timing and degree. The results of studies on 30 children, each tested with Creon, Creon 25000 and Pancrease HL will be reported.