Views on the existence of a negative feedback between pancreatic secretion and intraduodenal of proteases in humans are controversial. The objective of the study was to find out whether enzyme substitution will have an impact on pancreatic enzyme secretion and pain in chronic pancreatitis. The preparation Panzytrate 2500 (2x3 capsules/day containing 1250 units of proteases per capsu- le) was administered for a 4-week period. In 18 patients with chronic pancreatitis (7 with the severe and 11 with the medium severe and mild form of pancreatitis )the faecal and serum pancreatic elastase was assessed one day before and one day after enzyme substitution therapy. A significant reduction of the faecal elastase concentration (p =0.03) and serum elastase (p = 0.00375) was recorded in patients with mild and medium severe CP. The values of faecal and serum pancreatic elastase 1 were insignificantly reduced also in patients with severe chronic pancreatitis.Pain relief was statistically significant already after two weeks´ administration of enzyme substitution therapy (p =0.0233) and after four weeks´ treatment (p =0.00766). The results support the importance of the negative feedback on regulation of pancreatic secretion and the positive effect of substitution therapy on pain in chronic pancreatitis.

        Key words: Chronic pancreatitis - Faecal and serum elastase.