ENZYMATIC ESPAVEN: WHAT IS IT FOR, SIDE EFFECTS, DOSAGE - MEDICINE - 2024

The enzyme Espaven is a medication indicated for dyspepsia, a disease caused by poor digestion of food. Among the associated symptoms we find bloating (abdomen bulging due to excess gas), irritable bowel syndrome, pancreatic insufficiency or inadequate digestion of fats.

It is a highly recommended drug in most cases, being one of the most consumed in the last decade to combat this type of gastrointestinal ailment. However, it also has some contraindications that will be detailed later.

Enzyme Espaven is a commercial brand that is usually presented in boxes of 10, 24, 40, 50 or 60 tablets, although this may depend on the pharmaceutical industry of each nation.

Composition

Enzymatic Espaven has multiple components, each with a specific function within the formulation. The composition of this drug is as follows:

- 1% pancreatin.

- Dimethicone.

- Cellulase.

- Dry extract of ox bile.

Due to the complex chemical interactions that take place during the digestive process, none of the enzymatic Espaven compounds are effective when administered in isolation; hence the need for dosing together.

Mechanism of action

Each of the components of enzymatic Espaven has a specific therapeutic effect. The relief of the symptoms of dyspepsia is the result of the synergy of all the individual effects.

Pancreatin

It is an enzyme similar to pancreatic amylase that helps the digestion of proteins and carbohydrates by facilitating their hydrolysis (breaking down into their smallest components).

This is one of the key components of the enzymatic Espaven, since it allows it to be effective in cases of pancreatic insufficiency; that is, when the patient's pancreas does not produce enough enzymes for digestive processes to carry out normally.

Ox bile dry extract

Since fats do not mix with water and most of the intestinal content is water, the lipid components need to be emulsified in some way in order to be digested, and that is precisely the function of bile.

However, in some patients the production of bile is not enough to fulfill this function. There are even cases in which, being sufficient its specific chemical characteristics, make it less effective.

In these situations exogenous (external) bile is administered so that the fats present in the food can be emulsified and digested; otherwise, the patient could present symptoms such as abdominal distention, pain, diarrhea, and even steatorrhea (undigested fat in the stool).

Likewise, in patients with a normal and chemically perfect amount of bile (which works without problems) it may be the case that digestive discomfort occurs when a copious meal is richer in fat than normal, so exogenous bile is also useful.

Dimethicone

Its function is to reduce the surface tension of fluids within the intestine. In this way there is less tendency to the formation of bubbles and the gases produced by digestion tend to dissolve more easily.

Dimethicone is the most important component in reducing the sensation of bloating and flatulence.

Cellulase

It is an enzyme derived from a fungus known as Aspergillus niger. This enzyme is able to digest cellulose (a compound carbohydrate) in plant fibers, something that humans cannot do because they lack the enzyme.

Most people do not have any discomfort associated with the inability to digest fibers, since the bacteria in the intestinal flora are responsible for this process. However, on some occasions symptoms with abdominal distension or pain may occur, because the fermentation process of the fibers produces a lot of gas.

In these cases the person experiences symptoms of dyspepsia when consuming insoluble fibers, the administration of cellulase being necessary in order to facilitate the hydrolysis of cellulose.

This in the end will reduce the digestive symptoms associated with the fermentation process of the fibers at the level of the bacterial flora, because the enzyme acts faster than the bacteria reducing the substrate so that they can degrade the fibers in a natural way.

What is the enzymatic Espaven used for?

Older adult with digestive problems

Enzymatic espaven is useful in cases of dyspepsia. This condition is a digestive disorder that occurs after a food intake. The most obvious symptoms are heaviness, stomach pain, burning or flatulence. Among the conditions of all the above are:

- Steatorrhea (undigested fat remains in the stool).

- Irritable bowel syndrome (also known as irritable bowel syndrome).

- Pancreatic insufficiency.

- Various deficiencies of digestive enzymes.

- Meteorism and / or flatulence.

- Food transgressions (copious meals, very rich in fat).

In general, in any case of dyspepsia this medicine can help. However, it is very important not to self-medicate and consult a doctor, since although most cases of dyspepsia are due to benign diseases, there are also the case of very serious conditions.

Some of these conditions are pancreatic cancer, peptic ulcer disease and even gastric cancer, whose symptoms are very similar to dyspepsia although their treatment is totally different.

Contraindications

- The main contraindication is known hypersensitivity (allergy) to any of the components.

- Its use should be avoided in cases of hepatitis or bile duct obstruction.

- It should not be mixed with alcohol as it decreases its effectiveness.

- It should be used with caution in patients receiving some medications such as ciprofloxacin, ranitidine, folic acid, famotidine and phenytoin (the list is much longer, so it is recommended to consult with the doctor before using this medicine concomitantly with another drug).

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Side effects

- Being a local action drug (within the digestive tract) with poor absorption, systemic effects are not usually common. However, certain adverse reactions can occur locally, the most common of which is diarrhea.

- It is possible that allergic reactions are triggered in patients sensitive to one or more of the components; in these cases use should be discontinued and alternative therapeutic options should be sought.

- In cases of pregnancy and lactation, controlled clinical studies of safety for the fetus have not been carried out, so it is preferable to avoid it unless there is no safer option and the symptoms of dyspepsia are disabling for the mother.

Recommended dosage

Enzymatic Espaven is effective by taking 1 or 2 tablets after each meal, three times a day. It should not be administered to patients under 12 years of age or during pregnancy, lactation and pediatrics.

References

1. Stone, JE, Scallan, AM, Donefer, E., & Ahlgren, E. (1969). Digestibility as a simple function of a molecule of similar size to a cellulase enzyme.
2. Schneider, MU, Knoll-Ruzicka, ML, Domschke, S., Heptner, G., & Domschke, W. (1985). Pancreatic enzyme replacement therapy: comparative effects of conventional and enteric-coated microspheric pancreatin and acid-stable fungal enzyme preparations on steatorrhoea in chronic pancreatitis. Hepato-gastroenterology, 32 (2), 97-102.
3. Fordtran, JS, Bunch, F., & Davis, GR (1982). Ox Bile Treatment of Severe Steatorrhea in an Ileectomy-Ileostomy Patient. Gastroenterology, 82 (3), 564-568.
4. Little, KH, Schiller, LR, Bilhartz, LE, & Fordtran, JS (1992). Treatment of severe steatorrhea with ox bile in an ileectomy patient with residual colon. Digestive diseases and sciences, 37 (6), 929-933.
5. Schmidt, A., & Upmeyer, HJ (1995). US Patent No. 5,418,220. Washington, DC: US ​​Patent and Trademark Office.