From the Guidelines
Pancreatin and sodium tauroglyconate should not be taken as primary treatments for elevated liver enzymes or hepatitis, as they do not address the underlying causes of liver inflammation or enzyme elevation. While pancreatin is a digestive enzyme supplement that can help with nutrient absorption in conditions like pancreatic insufficiency, and sodium tauroglyconate (a bile acid) may assist with fat digestion, neither addresses the underlying liver condition [ 1 ]. For hepatitis and elevated liver enzymes, treatment should instead focus on the specific cause, which might include antiviral medications for viral hepatitis, lifestyle modifications like alcohol cessation, weight management for fatty liver disease, or discontinuation of hepatotoxic medications [ 1 ].
Key Considerations
- The management of elevated liver enzymes and hepatitis requires a thorough evaluation to exclude other causes of liver injury, including viral hepatitis, biliary obstruction, and drug-induced liver injury [ 1 ].
- Patients with cancer are at elevated risk for liver injury from various causes, and all patients on immune checkpoint inhibitor (ICI) therapy with elevated liver chemistries should be evaluated for alternative etiologies for their hepatitis [ 1 ].
- Current treatment guidelines for ICI hepatitis are based largely on expert opinion and small case series, emphasizing the need for individualized care and consultation with a healthcare provider [ 1 ].
Recommendations
- Anyone with elevated liver enzymes or hepatitis should consult with a healthcare provider for appropriate diagnosis and treatment rather than self-medicating with supplements like pancreatin and sodium tauroglyconate.
- Treatment should be tailored to the specific cause of liver inflammation or enzyme elevation, and may include antiviral medications, lifestyle modifications, or discontinuation of hepatotoxic medications [ 1 ].
- Digestive aids like pancreatin and sodium tauroglyconate may be considered as supportive care for patients with advanced liver disease who develop digestive issues as a secondary problem, but they should not be used as primary treatments for hepatitis or elevated liver enzymes [ 1 ].
From the Research
Elevated Liver Enzymes and Hepatitis
- Elevated liver enzymes are a common finding in patients with hepatitis, and can be caused by various factors such as viral hepatitis, genetic liver diseases, and drug-induced liver diseases 2.
- The pattern of liver enzyme elevation can help distinguish between different types of liver disease, including hepatocellular and cholestatic liver disease 3.
- In patients with hepatocellular liver injury, serum alanine (ALT) and aspartate (AST) aminotransferases are typically elevated, while in patients with cholestasis, serum alkaline phosphatase (ALP) levels are elevated 3.
Pancreatin and Sodium Tauroglyconate
- There is no direct evidence in the provided studies to suggest that pancreatin and sodium tauroglyconate can be taken in elevated liver enzymes and hepatitis.
- However, the studies suggest that elevated liver enzymes can be caused by various factors, and that a thorough diagnostic approach is necessary to determine the underlying cause of the elevation 2, 3, 4, 5, 6.
Diagnostic Approach
- A systematic diagnostic approach is necessary to determine the cause of elevated liver enzymes, and may include laboratory tests, imaging studies, and clinical evaluation 2, 3, 4, 6.
- The pattern of liver enzyme elevation can help guide the diagnostic approach, and may suggest the presence of hepatocellular or cholestatic liver disease 3.