FLATULENCE

Flatulence is the presence of gas in stomach or colon. It is relieved by the administration of substances known as carminatives. Carminatives are preparations of cardamom, dil, ginger, coriander, clove, etc, as well as alcoholic solution of ether and chloroform. The volatile oil in certain liqueurs may work as carminatives.
Carminatives act by two mechanisms:
They help in generating belch and eructation.
They cause passage of flatus. This may be due to the retention of carminative in GIT through which they stimulate the movement of GIT and relaxed sphincter.
Simethicone is a polymer, used as deforming action which helps gas bubbles to coalesce and it is recommended to be used as anti-flatulent. It is neither absorbed nor irritant to GIT. It is used in combination with other antacids.
PANCREATIN: Pancreatin preparations contain principally amylase, proteases and lipases (all the enzymes are in active form). It is prepared from . These preparations are used for the treatment of mainly two conditions:
v Pancreatic insufficiency
v Pancreatitis
PANCREATIC INSUFFICIENCY: An insufficiency of pancreatic secretion results in incomplete digestion and undigested meat fibers are present in the feces ( ). There may also be undigested fat in the feces (steatorrhea). If there is large fat intake, these digestive disorders may be collected by oral administration of pancreatin which is given in enteric form to protect the enzymes from inactivation by the gastric acid and pepsin.
While treating pancreatic insufficiency, it is necessary to monitor daily stool-fat excretion and make appropriate adjustment in the dose to achieve desired therapeutic effect.
Supplementation of the therapy with H2 receptor antagonist enhances the effectiveness of enzymes, presumably by decreasing the destruction of the enzyme activity by gastric acid and pepsin.
PANCREATITIS: It is acute or chronic inflammation of pancreas which in due to auto-digestion of pancreatic tissue by its own enzymes. In the process of pancreatic pro-enzymes becoming activated within the land, the enzymes attack the pancreatic tissue causing necrosis and pain. This condition is called Pancreatitis. Due to this condition ascribed to activation of pancreatic juice by a reflux of bile into the pancreatic duct and to rupture the walls of duct, due to increased pressure developing in it. Nearly half of the cases of Pancreatitis are in persons who are dependant on alcohol or on opiate. Susceptibility of alcohol dependence is not fully known while the opiates produce the spasm of sphincter of oddi and is presumed to be responsible for high rate of pancreatitis occurrence in opiate dependant. Intra-abdominal administration of protease inhibits the secretion of CCK and thence secretion of pancreatic enzyme. With this rational oral administration of pancreatin is used to reduce pancreatic stimulation and decrease intraductal pressure and relieve pain.
SIDE EFFECTS: The high doses causes nausea, diarrhea, and hypernatremia because the enzyme preparation contain high purine contents, uric acid, renal stones may be seen as side effects of pancreatin therapy.