Maldigestion is an impaired breakdown of nutrients through either lack of digestive enzymes and/or gastric acid production issues. This in turn causes malabsorption, as nutrients are not broken down into useful absorbable components, which then causes malnutrition. With EPI, you are slowly and painfully starving to death, first nutritionally and eventually completely. Your muscle tissue and bones are used up internally as nutrient fuel. This is when pancreatic enzymes come into the picture.
Pancreatic enzymes are absolutely crucial for survival and to improve quality of life when you have EPI. The generic term for these enzyme pills is Pancrelipase. I have been prescribed Pancrelipase pills called Creon as well as Pancreaze, which are some of the few prescription brands of pancreatic enzyme replacement pills. They are essentially pancreatic enzymes such as lipase, amylase and protease from a pig’s pancreas in tightly controlled quantities.
PERT or Pancreatic Enzyme Replacement Therapy is getting a prescription of one of the available Pancrelipase medications and start dialing in the quantities you need for your personal situation and diet. This will take a bit of trial and error in the beginning, but many doctors start with 36,000 units of lipase, which is how the pill sizes are noted as. They all contain amylase and protease as well at different quantities, and in addition many are enteric coated.
Enteric coated
Importantly, the Pancrelipase pills need to be able to get through the stomach acid bath into the duodenum where the pancreatic enzymes are needed for further digestion, therefore many of them are enteric coated.
There are also many over the counter digestive and vegetarian type of enzyme supplements containing, e.g., bromelain and papain. But, this will not be sufficient because of how crucial it is to get very specific and controlled amounts of enzymes for each meal, as well as likely not being enteric coated.
Some FDA approved Pancrelipase medications that are available are:
● Creon®
● Pancreaze®
● Pertyze®
● Ultresa®
● Viokace®
● Zenpep®