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Pancreatic Enzymes and PPIs

Posted , 4 users are following.

raja-sam
raja-sam

Recently diagnosed with CP after doing a EUS. Maintaining low fat diet 20g n less of fat per day, as close to 0g fat as I can get. Pancreatic enzymes have been discussed with the Dr. Issue is that Dr says they need to be administrered along with a PPI. I've had very adverse effects in the past with PPI's and twice PPI's induced AP for me. I know there are two types of enzymes, entric coated and non entric coated. The question is can creon, or cotozme be used without a PPI if the pill is entric coated. If so I can push the Dr to perhaps try this method of treatment.

0 likes, 3 replies

3 Replies

  • Reefsider
    Reefsider raja-sam

    Posted

    Hi there raja-sam, I assume your doctor is a gastroenterologist?  Re the fat issue, I have CP and have always followed a relatively low fat diet even before diagnosis, that is I've never consumed fast foods which can be (wrong type) fat laden, and hate fatty foods generally although I continue to eat tuna in oil and salmon.  My gastro guy told me I should continue that, that no fat is not a good idea.  I'm not sure if that advice is debatable?  He specialises in all to do with the pancreas.  I'll ask him when I see him in two weeks and get back about it.  It might be worth a stand alone discussion actually.

    As for the use of pancreatic enzymes.  I take Creon which is enteric-coated and I take Omeprazole and APO-Ranitidine.  PPI's have taken over from ranitidine it seems.  Proton-pump inhibitors (PPIs) are more effective for the prevention of NSAID-induced ulcers apparently.  I have no clue about them actually I just looked that up but I'm learning about CP and stomach ulcers all the time lately. If you've had a negative reaction to PPI's in the past, provide the proof to your doc.  It seems a no brainer to avoid them to me and I'd certainly ask about alternatives. 

    I'd not survive without my Creon given the amazing and almost instantaneous improvement I felt after not absorbing nutrients for a very long time.

    It really is a matter of being totally confident with your doctor, if you have any doubts given CP is a life long issue, you can get another opinion.  It sounds like you have a few seeds of doubt about your doctor. 

    • raja-sam
      raja-sam Reefsider

      Posted

      Thank you Reefsider my GI Doctor says that enzymes can only be taken with PPis as the stomach acide will destroy most of the enzymes. And in my case since PPis have induced AP twice, its best to avoid a third attack. Its best to maintain a low fat diet of 40 to 60 g of fat daily. 

      Seems reasonable, but my thoughts are is this true, what happens if I take enzymes without a PPI. Or, is there a type of enzyme that can be used without a PPi. 

      THe Dr, says my pancreas is still funcitoniong as you need more then 90% of you pancreas to be damaged for it not to function, or in other words you only need at least 10% of a functioniong pancreas to digest food.

      So my Dr says i would be okay to maintain a low fat zero alchol lifestyle. And take medication to control the pain.

      Obviously i'm here on the forums to get more thoughts as I dont know much. And if possible I would like to enjoy a more broader diet.

  • pete70517
    pete70517 raja-sam

    Posted

    Hi Raja-sam,

    Just read your post and I'm wondering how you measure the amount of fat you eat every day. I was recently diagnosed with AP and told to follow a low fat diet. But, could you give me some examples of the fat that you eat and how you measure it? many thanks.

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