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Pancreatic Functions | Enzyme Therapy
 
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.

 
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
  10,000 10,000 12,000 8,000
  16,000 20,000 20,000 20,000
    25,000    
 

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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