Enzyme replacement supplements
The pancreas produces digestive enzymes to help break down food. When you have pancreatic cancer, or have had pancreatic surgery, your body may not be able to make enough of these digestive enzymes. This will affect your ability to digest food, particularly fat and protein, and to absorb vital nutrients. This is often referred to as pancreatic exocrine insufficiency (PEI).
Signs of PEI include:
- abdominal pain
- bloating and excessive wind
- diarrhoea or oily stools that are pale in colour, frothy, loose and difficult to flush
- weight loss.
To help prevent these symptoms, your doctor may prescribe pancreatic enzymes (e.g. CREON), sometimes with acid-suppressing medicine. The dose will be adjusted depending on your symptoms and diet. It may take time to get this balance right. A dietitian can help you and your doctor work out the correct dose.
Taking enzyme supplements
- Take enzyme capsules with water and the first mouthful of food to ensure adequate mixing. With larger meals, you may also need to take them halfway through the meal.
- Always take enzymes when having food or drink that contains fat or protein. Slightly higher doses may be needed with high-fat meals, e.g. fried foods, pizza. You don’t need to take enzymes for simple carbohydrates that digest easily, e.g. fruit, fruit juice, black tea, coffee.
- Take enzyme supplements as prescribed. Do not change the dose without talking to your doctor or dietitian first.
Podcast: Appetite Loss and Nausea
Download a PDF booklet on this topic.
Dr Benjamin Loveday, Hepato-Pancreato-Biliary (HPB) Surgeon, Royal Melbourne Hospital and Peter MacCallum Cancer Centre, VIC; Dr Katherine Allsopp, Palliative Medicine Physician, Crown Princess Mary Cancer Centre, Westmead Hospital, NSW; Hollie Bevans, Senior Dietitian, Radiotherapy and Oncology, Western Health, VIC; Dr Lorraine Chantrill, Head of Department Medical Oncology, Illawarra Shoalhaven Local Health District, NSW; Amanda Maxwell, Consumer; Prof Michael Michael, Medical Oncologist, Lower and Upper GI Oncology Service, Co-Chair Neuroendocrine Unit, Peter MacCallum Cancer Centre and University of Melbourne, VIC; Dr Andrew Oar, Radiation Oncologist, Icon Cancer Centre, Gold Coast University Hospital, QLD; Meg Rogers, Nurse Consultant Upper GI/NET Service, Peter MacCallum Cancer Centre, VIC; Ady Sipthorpe, 13 11 20 Consultant, Cancer Council WA.
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