Unprotected pancreatin

Pharmaceutical inhibition of gastric acid output (proton pump inhibitor, H2 receptor blocker) may have beneficial effects when combined with an unprotected pancreatin preparation, not only by protection of enzymes during their gastric passage, but also by increasing duodenal pH and thereby improving enzymatic action. (Note that, in chronic pancreatitis, duodenal pH is lower due to impairment of pancreatic bicarbonate secretion, see above). 

Although the small, coated pancreatin preparations have been shown to be superior compared with unprotected pancreatin extracts, it should be noted that enzyme release requires several minutes after exposure to the intestinal milieu. This may further delay digestive action and shift the site of maximal absorption more distally this pathophysiological mechanism is exacerbated by accelerated gastrointestinal... 

---