Pancreatin in Pregnancy

Drug Pancreatin is an enzyme preparation that promotes normal digestion. Other trade names for this drug are: Mezim, Biosim, Gastenorm, Normoenzyme, Enzistal, Pancreasim, Pancitrat, Festal, Enzibene, and others.

The appointment of certain medications during pregnancy in a significant proportion of clinical cases is controversial. So, many pregnant women who are faced with digestive problems, are interested in the question, can pancreatin be used in pregnancy?

To make the answer convincing and, most importantly, reasonable, let's see what information is given by the official instruction to pancreatitis during pregnancy.

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Indications for the use of pancreatin in pregnancy

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

Indications for the use of pancreatin in pregnancy, as well as outside it, include inflammation of the pancreas (chronic pancreatitis), cystic fibrosis (genetic disease of the pancreas), chronic pathology of the gastrointestinal tract, liver, gallbladder and large intestine. As well as digestive disorders due to malnutrition. Doctors can prescribe pancreatin to bedridden patients and when preparing patients for an X-ray study or ultrasound of the abdominal cavity and its organs.

However, no chronic constipation, no heartburn, no nausea, which many pregnant women experience, there is no pancreatin in the list of applications. And it can not be.

Because these symptoms are associated with a reduction in the contractile function of all smooth muscles characteristic for pregnancy and a gradual (as the size of the uterus increases) by changing the position of the stomach. And here there is no connection with the lack of digestive enzymes.

So the doctor's permission to use pancreatin during pregnancy can be caused solely by the presence in the anamnesis of the pregnant woman of the aforementioned diseases of the gastrointestinal tract and inflammation of the pancreas.

In addition, the use of pancreatin in pregnancy is stipulated in the instructions in special instructions, the literal wording of which has the standard form: "During pregnancy and lactation, the drug should be used only as directed by the doctor if the expected benefit to the mother exceeds the potential risk to the fetus and the baby."

Pharmacodynamics

Active agents of pancreatin are enzymes of pancreas of pigs - amylase, lipase and protease. Pharmacodynamics pancreatin in pregnancy is based on a simple replenishment of the lack of its own enzymes of the pancreas of man. Getting into the stomach of the patient, 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 in the instruction is practically not commented. It is noted only that the enzymes contained in the preparation - thanks to the acid-resistant shell of tablets, capsules and dragees - begin to act not in the stomach, but in the small intestine, which has an alkaline environment.

In this case, half an hour after taking pancreatin, its digestive enzymes reach their highest activity.

Dosing and Administration

The form of the release of pancreatin - tablets in the enteric coating, 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 on the content of enzymes. Calculation of the dosage is made (based on the enzyme lipase) per kilogram of body weight of the patient. So, for adults, the average single dose is 8000-24000 units (1-3 tablets), the maximum daily intake is 150,000 units.

Pancreatin (tablets, capsules, dragees) is taken whole in the process of eating or after eating and is washed down with a lot of water (not alkaline).

Data regarding whether an overdose of this medication is possible is not available.

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

The use of pancreatin in pregnancy in the first trimester

The first third of the birth of a new life since the moment of its conception is the most responsible. After all, in this period there is the birth and formation of all organs and systems of the organism of the future person. Therefore, any, even the slightest negative impact on this shaky balance can cause a failure in the normal development of the embryo.

The use of pancreatin in 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 adverse effects on the fetus, may decide to prescribe pancreatin, since the effects of the disease can significantly affect the normal course of pregnancy.

The use of pancreatin in pregnancy in the 2nd trimester

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

But in this period of time the woman is not immune from "medical trouble" - various kinds of diseases. Chronic pancreatitis can also make itself felt. Therefore, the use of pancreatin in pregnancy in the second trimester is completely permitted. But it is not superfluous to make a reservation once again that a drug can be prescribed only by an obstetrician - a gynecologist leading a pregnancy, a gastroenterologist or, at the very least, a district doctor, who must necessarily take into account the status of a woman.

No independent appointments and uncontrolled administration of the drug, if the woman subsequently does not want to face pathological changes in her condition, as well as with problems of dysgenesis (congenital maldevelopment of certain systems and organs, congenital malformation).

The use of pancreatin in pregnancy in the 3rd trimester

The human pancreas produces several specialized enzymes that specifically work on the cleavage and utilization of food constituents: an enzyme such as lipase is directed to the processing of fats, amylase is responsible for the processing of carbohydrates, and the protein component of the products processes the protease.

The result of the introduction of pancreatin in pregnancy is the normalization of the level of these enzymes, which contributes to the growth of the suction activity of the small intestinal mucosa, in a sufficient amount of adsorbing the substances necessary for the normal work of the whole organism.

As in the previous two trimesters, the use of pancreatin in pregnancy in the 3rd trimester is acceptable. But again, it's worth mentioning that a qualified doctor should give permission for the drug. The reason for this step is the difficult condition of the future mother, corresponding to the indications for using the pharmacological characteristics of the drug in question. In this case, the doctor must evaluate and the threat to the development of the fetus, which represents the introduction of the drug. And if the "scales" tends to the urgent need to stop the problem with the health of the pregnant woman, the drug is clearly attributed, but the reception is carried out under the constant supervision of the doctor, using the permissible methods of research and diagnosis.

Can pancreatin be used during pregnancy?

Predominantly after conception and against the background of the restructuring of the body, many pregnant women begin to feel problems with digesting food, exacerbating diseases affecting the digestive system. Many begin to get constipation, symptomatology of toxicosis, eructation, heartburn and other manifestations of exacerbation.

In such a period, any pharmacological preparations should be introduced with special care into the therapeutic or prophylactic protocol. Especially it is dangerous when a woman is engaged in self-medication, prescribing medicine and dosage. Such disorder can end in the deterioration of the patient's condition, complications in the development of the fetus, disabilities in his physical and psychological development. And in the worst case, you can get a spontaneous abortion.

To reduce pathogenic symptoms, without harming the unborn baby, only a qualified doctor can do it. He will not only diagnose, but will give recommendations and will assign adequate relief of the problem.

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

The purpose of taking this medication is worsening of the digestive system, and, more specifically, reducing the production of gastric secretions. This medicine helps to digest incoming products, as well as stimulating effect on gastric secretions, forcing them to work more actively.

This article examines the question, can pancreatin be used in pregnancy? Doctors answer, that it is possible, but the prescribing doctor, the leading woman's pregnancy, should still prescribe this medication.

To understand how a medicine works and if it does not harm other components of the body, it is first necessary to understand what happens to the woman's body after conception?

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

At the same time smooth muscle is 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 the spasms of the muscles of one organ are suppressed, they are also relaxed in others. Therefore, progesterone has a relaxing effect not only on the muscles of the uterus, but also on the smooth musculature of the organs of the gastrointestinal tract, which, naturally, can not but affect their work.

The peristalsis can also suffer, the work of the intestine 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 disturbance.

Gradually constipation passes into the chronic plane, which is justified by the long-term finding of fecal masses in the intestine. Decay of undigested residues is observed, toxins begin to be absorbed back into the blood, which carries the poison throughout the entire body of the pregnant woman. It is these toxins that cause all those negative symptoms that worsen the condition of a woman, negatively affecting the developing fetus.

The frequent occurrence of heartburn in a future mother is also explained not by an increase in the acidity of the gastric juice, which is the main cause of this symptom (the acidity level in some cases even decreases), but the consequence of the action of progesterone. With the relaxation of smooth muscles, not only the digestive tract becomes more sluggish, but the sphincter, the valve that separates the stomach from the esophagus, suffers. With a decrease in the force of spasms, reflux of the incompletely processed contents of the stomach back into the esophagus occurs, which causes heartburn.

As the gestation period increases, the uterus grows, increases in size, and begins to press on the intestines and stomach, as well as provoking a backward ejection.

Therefore, against the background of such changes, pancreatin during pregnancy seems to be enough not only appropriate, but also just necessary help in solving the problem that has arisen. But will he 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 stopped by the drug under consideration. Against the background of its reception, this problem can even worsen, as the constipation and symptoms that follow it (vomiting, heartburn, eructation, nausea) can even intensify. This fact is reflected in the side effects of pancreatin.

Not having received a positive effect in terms of improving defecation, do not count on the disappearance of concomitant symptoms (the organism's intoxication does not stop).

Therefore, if the reasons for the discomforting state of a woman lie precisely in this plane, the drug in question will not only help the pregnant body to remove this internal conflict, but also exacerbate the situation.

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

Enzymes, which are full 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, when introduced into the body, is not divided into parts, but is taken as a whole capsule.

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

It is only necessary to warn the women who are waiting for the child that they should not risk their health and the health of their unborn child (and in some cases, their lives) by prescribing this medication on their own. Only the doctor leading the pregnancy can adequately assess the situation, recognize the source of the problem and decide on the prescription of the medicine in question, coming to the prescribed dosage very carefully.

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Instructions for pancreatin in pregnancy

It should immediately warn the respondents that at present no clinical monitoring of pancreatin intake has been performed for the category of patients under consideration (women waiting for the child). Therefore, there are no data describing 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 - the manufacturer - is unconditionally denied is that the drug has teratogenic characteristics (the ability of the substance to disrupt the development of the tissues and organs of the fetus, leading to congenital malformations).

In the light of the foregoing, the instruction of pancreatin in pregnancy states that this drug is allowed to be used in this woman-specific period only if the need to stop the clinical picture of its pathology substantially outweighs the supposed, negative impact on the body of the developing embryo.

If necessary, pancreatin can be taken and at the time when a woman feeds her newborn baby with breast milk.

Developing this or that tool, pharmacologists pursue a certain goal. With the release of pancreatin, the main indications for its use were malfunctions arising in the process of digestion:

• The chronic stage of pancreatitis is an inflammatory-degenerative process in the pancreas.
• Cystic fibrosis is a systemic hereditary disease in which a protein that participates in the transport of chlorine ions through the cell membrane is mutated, resulting in disturbances in the work of endocrine glands, including the pancreas.
• Other disorders of the digestive system, leading to a disruption in their functioning, expressed as such symptoms: nausea, vomiting, diarrhea, flatulence and others.
• The process of digestion has failed, caused by a sedentary lifestyle.
• Violation of the ability to normal chewing food (bruise, fracture of the lower jaw, problems with teeth or dentures and so on).
• Wrong, irrational food.
• This drug can be prescribed by a doctor before some methods of ultrasound examination or radiography of internal organs in the abdominal and pelvic region.

Pancreatin is introduced into the body of a pregnant woman orally during a meal or immediately after the meal. The recommended average dosage of the drug is 150,000 units. This amount of the drug is determined by the level of liposis, the concentration of which is necessarily reflected in the package of the drug.

During pregnancy, a pharmacological drug is prescribed exclusively individually for each pregnant woman. Admission is necessarily conducted 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 stool to diagnose the level of functioning of the digestive system.

Contraindications to the use of pancreatin in pregnancy

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

Direct contraindications to the use of pancreatin in pregnancy, the instruction to the drug does not. A recommendation for its use in the treatment of pregnant women has already been given above.

[3], [4]

Side effects of pancreatin in pregnancy

Among the side effects of pancreatin in pregnancy (and with these gastrointestinal pathologies) are allergic reactions (especially with prolonged admission), increased uric acid levels in the urine (hyperuricosuria), abdominal pain, stool disorders (diarrhea or constipation).

Interactions with other drugs

Finally, we come to a point that will finally convince us that the instructions to medicines should be read carefully, especially if these drugs are prescribed for pregnant women ...

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

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

In addition, a decrease in absorption of folic acid and iron, which can cause pancreatin in pregnancy, guarantees anemia. And anemia threatens to delay the development of the fetus, placental abruption and premature birth.

Reviews of pancreatitis during pregnancy

In most cases, reviews of pancreatitis during pregnancy relate to the fact that many pregnant women are prescribed to drink with certain problems with digestion that occurred during the period of bearing a child, or with pains in the stomach ...

Although it is much easier to explain to the future mother that she does not need to drink soda, coffee and strong tea, do not eat fat and spicy, exclude mushrooms, beans, garlic, onions, cabbage and radish from the ration, and limit the use of sweets and sugar. Then many medications, including pancreatin during pregnancy, will not be needed.

In the era of global computerization, to receive feedback on pancreatitis during pregnancy is not a big deal, it is only necessary to launch a search engine with this requirement.

Women who underwent a problem pregnancy, whose stumbling block was a violation in the digestive system, which is associated with the recurrence of chronic pancreatitis (or the pathological changes cited above in the causes of such a clinical picture) are happy to share their experiences.

A lot of those who unreservedly believe doctors and accept everything they prescribe. In the case of pancreatin, most of the statements express grateful notes, discussing the implications for the appointment of this medication, which helped to lead to normal functioning of the body, giving them the opportunity to feel the joy of motherhood, rather than fixate on problems.

But there are those who complain that there were no prerequisites for taking this medication, but the doctor still prescribed this drug. After passing the course of therapy, to refuse taking pancreatin later turned out to be quite difficult, there was pain symptoms and other uncomfortable symptoms. In response to such a confession of a woman in childbirth, it is worthwhile to advise other women of childbearing age who are still planning to conceive, bear a child and motherhood, before registering for pregnancy, find out more different opinions about the doctor who will lead your pregnancy. Perhaps, it is necessary to replace the obstetrician-gynecologist and to be observed with another specialist, the benefit for today the pregnant woman has the right to this.

It is rare, through force, you can meet the confessions of those who risked prescribing this drug on their own. Part of what is called "carried" and unauthorized reception of the drug allowed them to normalize their disturbed digestion.

But is it worth the risk? This question is rather sparse, but those who have not been lucky and whose self-medication have led to the already congenital disability of the newborn baby tell with a feeling of pain, and even the health of the woman in labor leaves much to be desired.

When there is a need for drug intervention, it should be remembered that by coping with one problem, medicines almost always affect the entire body as a whole. And not always the given influence favorably influences other functional components of an organism. Especially it becomes actual at a time when a woman is nurturing her baby, because in such a period the mother's organism and the developing organism of the fetus are one. Therefore, the occurrence of discomfort caused by disorders associated with the digestive tract should not be ignored. But also to solve the arisen problem urgently, independently appointing to itself treatment, does not follow. In this case, expert assistance is required. The doctor correctly diagnoses the disease and gives the necessary recommendations. If there are prerequisites, and the clinical picture requires medication, the obstetrician-gynecologist can prescribe pancreatin during pregnancy, but it must be administered under the constant supervision of a specialist. If the doctor has appointed or nominated - to mean a preparation to accept necessarily follows, having finished treatment before full recover. Moreover, the developers of the drug insist on its teratogenic inertness.