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| G I Issues |
| Pancreatic Functions
| Enzyme Therapy |
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Enzyme Therapy
When taken with meals and snacks, pancreatic enzymes will correct
or partially correct the maldigestion problems in people whose pancreas
does not work. Enzyme therapy also improves symptoms such as bloating
and abdominal pain and leads to weight gain if a child is malnourished.
Patients with SDS generally respond well to enzyme replacement therapy.
The dose of enzymes needs to be adjusted according to the amount of
food that is eaten and should be increased as children grow. Never
increase the dose excessively without consulting your doctor. The
use of extremely high doses has been associated with severe complications
in patients with cystic fibrosis. Enzymes are required
for foods containing fat, protein and starch – for example milk,
bread, meat. Enzymes are not required for foods that contain simple
sugars alone – for example fruits, fruit juices, soft drinks, jello,
plain candies, popsicles etc
There are multiple commercial preparations, all of which come in
different strengths. It is very important to recognize the strength
of the preparation you/your child is taking. Examples of some of
the preparations available in Canada and the USA are shown below.
Some are available in capsules containing enzyme powder. Others
are capsules containing micro tablets or beads of enzymes. The enteric
coated products (ECS) have an outer coating that protects the enzyme
from being destroyed by stomach acid.
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| Pancreatic Enzyme Replacement Therapy
– Units of Lipase per capsule |
| Product |
Pancrease MT |
Creon |
Ultrase MT |
Cotazym |
| Powder |
N/A |
N/A |
N/A |
8,000 |
| ECS |
4,000 |
5,000 |
4,000 |
4,000 |
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10,000 |
10,000 |
12,000 |
8,000 |
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16,000 |
20,000 |
20,000 |
20,000 |
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25,000 |
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Here are a couple of links to how the Cystic Fibrosis organization
gives advice on enzyme information and guidelines.
Nutrition:
Pancreatic Enzyme Replacement in People with Cystic Fibrosis
CF
Health Matters: Enzyme Guidelines for Children with Cystic Fibrosis
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