Postprandial cholecystokinin response in patients with chronic pancreatitis in treatment with oral substitutive pancreatic enzymes.

Cholecystokinin (CCK) response to a test mealshould be increased in patients with pancreaticinsufficiency, as trypsin is absent from the duodenum.If pancreatic enzymes are added, a restoration of the inhibitory feedback should result in lowerlevels of CCK. Ten patients with chronic pancreatitisand steatorrhea were studied. CCK basal and postprandiallevels were evaluated the day before and 45 and 90 days after treatment with oral pancreatin.Twelve healthy volunteers were included as referencegroup. CCK basal levels did not vary. CCK response to atest meal was increased in patients before treatment and diminished when oral enzymes weremaintained for months even after three days of therapywithdrawal. We conclude that long-term therapy with oralenzymes induces changes in CCK response that do not regress after three days of treatmentsuspension.