Pancreatic enzyme supplements

Hi all;

I’ve been having GI issues for a year or so. Was recently diagnosed with a pancreatic enzyme insufficiency causing fat malabsorption, although fortunately a pancreatic ultrasound done through an endoscopy shows no sign of anything else wrong (i.e. no sign of pancreatitis). My doctor prescribed Creon which is a pancreatic enzyme supplement, but when I took it, it caused stomach aches and my IBS returned full force. Anybody else had this reaction, and what did you do for subsequent treatment?



I have had horrible stomach/gastro issues for the past 15+ years. The only thing that has helped was stabilizing my blood sugar with dexcom (try my best-but not great) and Creon. I also became a vegan about 2 years ago and think that has helped. It never goes away and I go through periods when it gets really bad. Do you limit the fat you eat? Are you sure you are taking the right amount? Did it get worse or just not improve?

I also have gastroparesis which is common in T1D. Have you been checked for this? I believe the vegan diet has really helped this despite being told that people with GP should eat highly processed foods.

Thanks, Casey. Some additional information: My case is not straightforward at all, though I’m not sure anyone’s is!

I was on NSAID’s for 6.5 years for chronic pain issues, so that may be contributing to IBS symptoms. I’ve also travelled a lot and have gotten sick in foreign countries, most recently in Egypt in Dec 2010. I’ve been tested for weird parasites and bugs, but as I understand it, just getting sick and having to take strong antibiotics can contribute to later IBS or contribute to the balance of gut bacteria being off even if the antibiotics cured the original problem.

I’ve been type 1 for 40 years. My control is pretty good. All my A1C’s in the past 6-7 years have been between 6.5 to 7, most towards the lower end of that. Given the amount of travel and my lifestyle and the fact that my low blood sugars increase in frequency dramatically as I tighten control, my endocrinologist is doubtful that trying to get much tighter than 6.5 might not boomerang and be counterproductive.

Breath tests show that I produce a lot of methane, much more than normal, even for a fasting baseline reading so I may have some SIBO. Breath tests also show that I’m highly lactose intolerant.

For one of my endoscopies, the doctor noticed there was still a little food left in my stomach so I was tested for gatroparesis. I was borderline - a little slower than normal for the first two hours, but just within normal for the third and fourth.

I’ve been following a low FODMAP diet, which seems to be controlling things most of the time. When I went on Creon, my IBS returned which in my case takes the form of 2-4 days of constipation followed by a day of stomach cramps and the backlog in my system all being cleared out. We tried lowering the dose but it kept getting worse. After a month, with my doctor’s support I stopped taking it and immediately started to feel better although it took another full month before my system was sorta back to equilibrium.

The FODMAP diet seems to keep things manageable but we know I still have the fat malabsorption and enzyme insufficiency so we’re debating whether I should try another pancreatic enzyme supplement. As I understand it, other formulations are available through Canadian pharmacies, and I’m actually a Canadian citizen with a green card living in the US so I could do that. I just wondered if anyone else had found they couldn’t tolerate Creon and what they did.