Pancreatin in pregnancy

The medicine Pancreatin is an enzyme preparation that promotes normal digestion. Other trade names of this medicine: Mezim, Biozim, Gastenorm, Normoenzyme, Enzistal, Pancreazim, Pancitrate, Festal, Enzibene, etc.

The prescription of certain medications during pregnancy is controversial in a significant proportion of clinical cases. Thus, many pregnant women who face digestive problems are interested in the question: is pancreatin allowed during pregnancy?

To ensure that the answer is convincing and, most importantly, justified, let's look at what information the official instructions for pancreatin during pregnancy provide.

[ 1 ]

Indications for the use of pancreatin during pregnancy

Among the general indications for the use of this pharmaceutical drug is such a pathology as secretory dysfunction of the pancreas, in which the production of digestive enzymes (trypsin, chymotrypsin, carboxypeptidase, steapsin, amylase, lipase) is significantly reduced. This leads to a decrease in the breakdown of proteins, fats and carbohydrates entering the body.

Indications for the use of pancreatin during pregnancy, as well as outside of it, include inflammation of the pancreas (chronic pancreatitis), cystic fibrosis (a genetic disease of the pancreas), chronic pathologies of the gastrointestinal tract, liver, gall bladder and colon. As well as digestive disorders due to improper nutrition. Doctors can prescribe pancreatin to bedridden patients and when preparing patients for an X-ray examination or ultrasound of the abdominal cavity and its organs.

However, neither chronic constipation, nor heartburn, nor nausea, which many pregnant women experience, are on the list of pancreatin applications. And there can't be.

Because these symptoms are associated with the decrease in contractile function of all smooth muscles typical of pregnancy and a gradual (as the size of the uterus increases) change in the position of the stomach. And there is no connection with a lack of digestive enzymes.

So, a doctor’s permission to use pancreatin during pregnancy can only be caused by the presence of the above-mentioned gastrointestinal diseases and inflammation of the pancreas in the pregnant woman’s medical history.

In addition, the use of pancreatin during pregnancy is stipulated by the instructions in special instructions, the literal wording of which has a standard form: “During pregnancy and breastfeeding, the drug should be used only as prescribed by a doctor, if the expected benefit to the mother outweighs the potential risk to the fetus and child.”

Pharmacodynamics

The active substances of pancreatin are the enzymes of the pig pancreas - amylase, lipase and protease. The pharmacodynamics of pancreatin during pregnancy is based on the simple replenishment of the deficiency of the human pancreas's own enzymes. Getting into the patient's stomach, these enzymes promote better digestion of food and the breakdown of proteins, fats and carbohydrates contained in it. And this, in turn, ensures an increase in their absorption in the small intestine.

Pharmacokinetics

The pharmacokinetics of pancreatin during pregnancy are practically not commented on in the instructions. It is only noted that the enzymes contained in the drug - thanks to the acid-resistant coating of tablets, capsules and dragees - begin to act not in the stomach, but in the small intestine, which has an alkaline environment.

Moreover, just half an hour after taking pancreatin, its digestive enzymes reach their highest activity.

Method of administration and dosage

Pancreatin is available in the form of enteric-coated tablets, gelatin capsules and dragees.

All forms of pancreatin are intended for oral administration. The dose is determined individually - based on the analysis of pancreatic juice for enzyme content. The dosage is calculated (based on the lipase enzyme) per kilogram of the patient's body weight. Thus, for adults, the average single dose is 8,000-24,000 units (1-3 tablets), the maximum daily dose is 150,000 units.

Pancreatin (tablets, capsules, dragees) is taken whole during or after meals and washed down with plenty of water (not alkaline).

There is no data on whether overdose of this drug is possible.

[ 5 ], [ 6 ], [ 7 ], [ 8 ]

Use of pancreatin during pregnancy in the 1st trimester

The first third of the birth of a new life from the moment of its conception is the most responsible. After all, during this period, the birth and formation of all organs and systems of the body of the future person occurs. Therefore, any, even the most insignificant negative impact on this precarious balance can cause a failure in the normal development of the embryo.

The use of pancreatin during pregnancy in the first trimester, despite the lack of teratogenicity of the drug, is allowed only with the permission of a specialist. If the severity of the disease requires immediate relief, the doctor, despite the risk of negative impact on the fetus, may decide to prescribe pancreatin, since the consequences of the disease can significantly affect the normal course of pregnancy.

Use of pancreatin during pregnancy in the 2nd trimester

This is probably the most favorable period in the course of pregnancy. Toxicosis is usually left behind, and the weight of the "tummy" is not yet so great as to cause discomfort to the expectant mother when walking. It is during the second trimester that a woman begins to feel her baby more - the fetus begins to move.

But even in this period of time, a woman is not insured against "medical troubles" - various kinds of diseases. Chronic pancreatitis may also make itself known. Therefore, the use of pancreatin during pregnancy in the 2nd trimester is quite acceptable. But it would not be superfluous to once again stipulate that the drug can only be prescribed by an obstetrician-gynecologist who is monitoring the pregnancy, a gastroenterologist or, in extreme cases, a local doctor, who must take into account the woman's status.

No independent prescriptions or uncontrolled use of the drug, if the woman does not want to subsequently face pathological changes in her condition, as well as problems of dysgenesis (congenital underdevelopment of some systems and organs, congenital deformity).

Use of pancreatin during pregnancy in the 3rd trimester

The human pancreas produces several specialized enzymes that work specifically to break down and utilize food components: an enzyme called lipase is designed to process fats, amylase is responsible for processing carbohydrates, and protease processes the protein component of food products.

The result of the introduction of pancreatin during pregnancy is the normalization of the level of these enzymes, which promotes the growth of the absorption activity of the small intestinal mucosa, which adsorbs in sufficient quantities the substances necessary for the normal functioning of the entire body.

As in the two previous trimesters, the use of pancreatin during pregnancy in the 3rd trimester is quite acceptable by doctors. But again, it is worth mentioning that permission to administer the drug must be given by a qualified doctor. The reason for such a step is the serious condition of the expectant mother, which meets the indications for the use of the pharmacological characteristics of the drug in question. At the same time, the doctor is obliged to assess the threat to the development of the fetus, which the administration of the drug poses. And if the "scales" lean towards the need for urgent relief of the health problem of the pregnant woman, the drug is definitely prescribed, but the intake is carried out under the constant supervision of a doctor, using acceptable research and diagnostic methods.

Is it possible to take pancreatin during pregnancy?

Mainly after conception and against the background of the body's restructuring, many pregnant women begin to experience problems with digestion of food, and diseases affecting the digestive organs become aggravated. Many begin to be bothered by constipation, symptoms of toxicosis, belching, heartburn and other manifestations of exacerbation.

During such a period, any pharmacological drugs should be introduced into the treatment or prophylactic protocol with special caution. This is especially dangerous when a woman self-medicates, prescribing a drug and dosage. Such carelessness can end in a deterioration in the patient's condition, complications in the development of the fetus, and disturbances in its physical and psychological development. And in the worst case, you can get a spontaneous abortion.

Only a qualified doctor can reduce pathogenic symptoms without harming the unborn baby. He will not only make a diagnosis, but also give recommendations and prescribe adequate treatment for the problem.

Pancreatin is a pharmacological drug that contains special enzymes designed to process carbohydrates, dietary fats and proteins that enter the human body along with food.

The purpose of taking this drug is to worsen the functioning of the digestive system, and more specifically, to reduce the production of gastric secretions. This drug helps to digest incoming products, and also has a stimulating effect on gastric secretions, forcing them to work more actively.

This article discusses the question of whether pancreatin can be taken during pregnancy. Doctors answer that it can, but the attending physician who is monitoring the woman's pregnancy should still prescribe this drug.

To understand how a medicine works and whether it will harm other components of the body, you should first understand what happens to a woman’s body after conception?

Immediately after fertilization of the egg, the female body begins to intensively synthesize progesterone (female sex hormone), one of the functions of which is to prevent contractile activity of the smooth muscles of the uterus, since with its increased tone there is a real threat of losing the child (a miscarriage may occur).

At the same time, smooth muscles are present in the structure of almost all organs of the human body, and they all have a single innervation. That is, they have a common supply of organs and tissues with nerves, which ensures their connection with the central nervous system (CNS). Therefore, when stopping muscle spasms in one organ, their relaxation is observed in others. Therefore, progesterone has a relaxing effect not only on the muscles of the uterus, but also on the smooth muscles of the gastrointestinal tract, which, naturally, cannot but affect their work.

Peristalsis can also be significantly affected, the work of the intestines becomes more sluggish, contributing to poor digestion of food, stagnation, and, consequently, a tendency to constipation, nausea, vomiting, belching, heartburn and other symptoms of gastrointestinal tract dysfunction appears.

Constipation gradually becomes chronic, which is explained by the long presence of fecal matter in the intestines. Rotting of undigested remains is observed, toxins begin to be absorbed back into the blood, which spreads the poison throughout the pregnant woman's body. It is these toxins that cause all those negative symptoms that worsen the woman's condition, negatively affecting the developing fetus.

Frequent occurrence of heartburn in expectant mothers is also explained not by increased acidity of gastric juice, which is the main reason for this symptom (the level of acidity in some cases even decreases), but by the effect of progesterone. When smooth muscles relax, not only the digestive tract itself becomes more sluggish, but the sphincter, the valve separating the stomach from the esophagus, also suffers. When the strength of spasms decreases, reflux of incompletely processed stomach contents back into the esophagus occurs, which causes heartburn.

As the pregnancy progresses, the uterus grows, increasing in size, and begins to press on the intestines and stomach, also causing reflux.

Therefore, against the background of such changes, pancreatin during pregnancy seems not only appropriate, but also simply a necessary aid in solving the problem. But will it solve the problem of chronic constipation? It turns out - no.

The source of problems with defecation is a decrease in the motor activity of the digestive organs, which is not relieved by the drug in question. Against the background of its use, this problem may even worsen, since constipation and the symptoms that follow from its occurrence (vomiting, heartburn, belching, nausea) can even intensify. This fact is reflected in the side effects of taking pancreatin.

Without receiving a positive effect in terms of improving defecation, you should not expect the accompanying symptoms to disappear (the intoxication of the body will not be relieved).

Therefore, if the reasons for the woman’s discomfort lie precisely in this plane, the drug in question will not only not help the pregnant woman’s body to relieve this internal conflict, but will also somewhat worsen the situation.

But if the cause of pathological changes is reduced production of a complex of digestive enzymes that participate in the process of food processing, in this case we can talk about the need for supportive therapy, with the need to introduce these substances from the outside in the form of a drug. And pancreatin is quite capable of becoming such a drug.

Enzymes, which are complete analogues of organic substances produced by human organisms, are placed in a special shell, which allows them to be "delivered" directly to the place necessary for their effective work, being destroyed only under the influence of gastric juice. It is for this reason that this drug is not divided into parts when introduced into the body, but is taken as a whole capsule.

Against the background of the restructuring of the pregnant woman's body, many diseases begin to worsen, including chronic pancreatitis. It is this that provokes the deterioration of the synthesis of the necessary digestive enzymes by the pregnant woman's body, in such a situation one should count on pancreatin.

It is only necessary to warn women who are expecting a child again that they should not risk their health and the health of their unborn child (and in some cases, their life) by prescribing this drug to themselves. Only a doctor who is monitoring the pregnancy can adequately assess the situation, recognize the source of the problem and make a decision on prescribing the drug in question, approaching the prescribed dosage very carefully.

[ 2 ]

Pancreatin instructions during pregnancy

It should be immediately warned to respondents that to date, clinical monitoring of pancreatin intake, as applied to the category of patients under consideration (women expecting a child), has not been conducted. Therefore, there is no data characterizing the effect of the drug on other organs of the pregnant woman, as well as on the condition and further development of the fetus.

The only thing that the manufacturer unconditionally denies is that the drug has teratogenic properties (the ability of a substance to disrupt the development of tissues and organs of the fetus, leading to congenital deformities).

In light of the above, the instructions for pancreatin during pregnancy state that this drug is permitted for use during this critical period for a woman only if the need to relieve the clinical picture of her pathology significantly outweighs the expected negative impact on the body of the developing embryo.

If necessary, pancreatin can be taken during the time when a woman is breastfeeding her newborn baby.

When developing a particular drug, pharmacologists pursue a specific goal. When pancreatin was released, the main indications for its use were failures that occur in the digestion process:

• The chronic stage of pancreatitis is an inflammatory-degenerative process in the pancreas.
• Cystic fibrosis is a systemic hereditary disease in which a mutation occurs in a protein involved in the transport of chloride ions across the cell membrane, resulting in disturbances in the functioning of the glands of external secretion, including the pancreas.
• Other lesions of the digestive organs, leading to disruption of their functioning, expressed by the following symptoms: nausea, vomiting, diarrhea, flatulence, and others.
• A disruption of the digestive process caused by a sedentary lifestyle.
• Impaired ability to chew food normally (bruise, fracture of the lower jaw, problems with teeth or dentures, etc.).
• Incorrect, irrational nutrition.
• This drug may be prescribed by a doctor before certain ultrasound examinations or X-rays of internal organs in the abdomen and pelvis.

Pancreatin is administered to the pregnant woman orally during meals or immediately after finishing a meal. The recommended average dosage of the drug is 150,000 IU. This amount of the drug is determined by the level of lipose, the concentration of which is necessarily reflected on the packaging of the drug.

During pregnancy, the pharmacological drug is prescribed strictly individually to each pregnant woman. The intake must be carried out under the supervision of a specialist and regular monitoring of the degree of processing of carbohydrates, fats and proteins using a coprogram - a laboratory study of the patient's feces in order to diagnose the level of functioning of the digestive organs.

Contraindications to the use of pancreatin during pregnancy

This enzyme preparation is contraindicated in case of individual hypersensitivity to individual components; in acute pancreatitis; in exacerbation of chronic pancreatitis. It is not recommended to use pancreatin in the treatment of children.

The instructions for the drug do not contain any direct contraindications to the use of pancreatin during pregnancy. And the recommendation for its use in the treatment of pregnant women has already been given above.

[ 3 ], [ 4 ]

Side effects of pancreatin during pregnancy

Side effects of pancreatin during pregnancy (and with the above-mentioned gastrointestinal pathologies) include allergic reactions (especially with long-term use), increased levels of uric acid in the urine (hyperuricosuria), abdominal pain, and bowel disorders (diarrhea or constipation).

Interactions with other drugs

Finally, we come to the point that will finally convince you that the instructions for medications must be read carefully, especially if these medications are prescribed to pregnant women...

Manufacturers of pancreatin and its numerous generics (synonyms), describing the side effects of pancreatin during pregnancy (or rather, simply side effects) did not say a word about this. But, commenting on the interaction of pancreatin with other drugs, they indicated that the use of pancreatin can lead to a decrease in the absorption of folic acid, and in combination with other drugs reduces the absorption of iron.

We hope you have not forgotten that folic acid (vitamin B9) is not produced in the body, but it ensures normal protein metabolism, growth and cell division. If the body of the expectant mother does not receive folic acid in the early stages of pregnancy, there is a risk of developing a congenital defect of the neural tube of the fetus - spina bifida.

In addition, the reduction in the absorption of folic acid and iron, which pancreatin can cause during pregnancy, guarantees anemia. And anemia threatens delayed fetal development, placental abruption and premature birth.

Reviews of pancreatin during pregnancy

In most cases, reviews of pancreatin during pregnancy concern the fact that many pregnant women are prescribed to drink it for certain digestive problems that arose during the period of bearing a child, or for stomach pains...

Although it is much easier to explain to the expectant mother that she should not drink soda, coffee and strong tea, not eat fatty and spicy foods, exclude mushrooms, legumes, garlic, onions, cabbage and radishes from her diet, limit her consumption of sweets and sugar. Then many medications, including pancreatin during pregnancy, will not be needed.

In the era of global computerization, getting reviews about pancreatin during pregnancy is not difficult, you just need to launch a search engine with this requirement.

Women who have gone through a problematic pregnancy, the stumbling block of which was a disruption in the functioning of the digestive organs, which is associated with a relapse of chronic pancreatitis (or pathological changes, listed above in the causes causing such a clinical picture) are happy to share their experiences.

There are many who unconditionally trust doctors and take everything they prescribe. In the case of pancreatin, most of the statements express grateful notes, discussing the consequences of prescribing this medicine, which helped to normalize the body's functioning, returning them the ability to feel the joy of motherhood, and not dwell on problems.

But there are those who complain that there were no prerequisites for taking this medicine, but the doctor prescribed this drug anyway. After completing the course of therapy, it turned out to be quite difficult to refuse taking pancreatin later, pain symptoms and other uncomfortable symptoms appeared. In response to such a confession of a woman in labor, it is worth advising other women of childbearing age who are still planning to conceive, bear a child and become a mother, before registering for pregnancy, find out more different reviews about the doctor who will be monitoring your pregnancy. Perhaps it is worth changing your obstetrician-gynecologist and being observed by another specialist, fortunately, today a pregnant woman has the right to do so.

It is quite rare, through force, to find confessions of those who risked prescribing this drug to themselves independently. Some of them, as they say, "got away with it" and the unauthorized use of the drug allowed them to normalize their digestive disorders.

But is it worth taking such a risk? This question is answered rather sparingly, but with palpable pain, by those who were unlucky and their self-treatment led to a congenital disability of the newborn baby, and the health of the mother herself leaves much to be desired.

When there is a need for medical intervention, it should be remembered that by eliminating one problem, drugs almost always affect the entire body as a whole. And this effect does not always have a beneficial effect on other functional components of the body. This is especially true during the period when a woman is carrying her baby, because during this period the mother's body and the developing body of the fetus are one whole. Therefore, the occurrence of discomfort caused by disorders associated with the digestive tract should not be ignored. But you should not urgently solve the problem by prescribing treatment for yourself. In this case, qualified help from a specialist is needed. The doctor will correctly diagnose the disease and give the necessary recommendations. If there are prerequisites, and the clinical picture requires medical intervention, an obstetrician-gynecologist can prescribe pancreatin during pregnancy, but its intake should be carried out under the constant supervision of a specialist. If the doctor has prescribed it, then the drug must be taken, bringing the treatment to complete recovery. Moreover, the developers of the drug insist on its teratogenic inertness.