enzyme dose

[Guest guest]

Hi Shirley,

Like Fliss and Sue I also am treated in Liverpool, UK. I take an

average of Creon 6 x 40,000 with each meal. Less with breakfast, as

during sleep the pancreas stores up a small quantity of enzymes, and

more with evening meal which tends to be a larger meal than the

others.

I also take 1 or 2 Creon 40,000 with between meals snacks, even if

only a low fat biscuit. I take omeprazole as well to enhance Creon's

effect.

My pancreatitis presented with malabsorption rather than pancreatic

pain, but enzymes are sometimes used for reducing pain as well. In

this case the uncoated preparations are often preferred by doctors,

and given in conjunction with an acid-lowering drug such as

omeprazole to prevent their destruction by gastric acid. The reason

being that to prevent pain the enzyme has to act quickly in the

duodenum to exert a negative feedback on the pancreas (A coated

enzyme might be too slow). It does this by 'digesting' a protein

which is normally produced in the intestine in response to food, to

stimulate the pancreas.

(The protein is called cholecystokinin releasing peptide which

stimulates release of cholecystokinin which in turn stimulates the

pancreas to produce digestive enzymes, turning in on itself and

digesting itself causing pain).

Creon is regarded as a safe drug, but some coated enzymes with a

different coating to Creon, were implicated in a fibrosing condition

in the colon. This occurred mostly in children with cystic fibrosis,

and those high-dose preparations were banned from use by the FDA.

Creon has certainly helped me, both with stopping steattorrhoea and

with increased energy levels which were very low previously. I have

had no side effects from it. I still can't manage much fat however,

certainly nothing fried, no cakes etc.

As with most questions the opinion of a specialist pancreatologist

should always be sought, and medical opinion changes all the time as

new research becomes available.

I hope you are feeling well,

Best Wishes

Tony UK