What effect does stomach acid have on pancreatic enzymes in ZES?

In the context of Zollinger-Ellison syndrome (ZES), which is characterized by excessive gastrin secretion and consequently increased gastric acid production, stomach acid can significantly impact pancreatic enzymes. These enzymes, including lipase, amylase, and proteases, are crucial for digestion and are activated in the alkaline environment of the small intestine.

When there is an excess of stomach acid, as seen in ZES, the acidic conditions in the duodenum can lead to the inactivation of pancreatic enzymes. These enzymes are optimally active in a neutral to slightly alkaline pH and may not function properly in a highly acidic environment. The presence of excess acid can denature these enzymes, rendering them ineffective at breaking down food in the small intestine, which can contribute to various digestive issues seen in patients with ZES.

Therefore, the statement that stomach acid inactivates pancreatic enzymes is accurate, given that the effectiveness of these enzymes depends on the appropriate pH for their activity.