Anyone have chronic diarrhea while on digestive enzymes?

I take ZenPep and was told by my Dietician yesterday to increase 20,000 to 40,000. I was find yesterday until I ate Pesnut Butter late and then a half and hour later had loose stools, this is before I increased my dosage today. I am very high string and there is a lot of tension here and sonetinrs it seems to be related, because I can’t eat when anxious.

I have been eating nut butters at the suggestion of the hepatobiliary dietician at MSKCC to increase my calories, since animal fats don't do well with me. Saved my life I think. I like almond butter and cashew butter. Some of the high quality peanut butters can be good though. I have been eating Nutella as well, but very high in carbs. I found a chocolate/hazelnut butter by Justin, much lower in carbs, tastes good. I take three 36K Creon with each meal, don't try and adjust my dose.

Your post is helpful. I am going to try 3 Zenpep at all meals. I have to gain 10 lbs. Did you have to gain weigh? And I thought Nutella had sugar. I don’t have diabetes, so I stay away from sugar. Just can’t get consistent. BM. Three days they are good, then I’ll eat something I always ate and the diarrhea returns. Maybe it’s because the enzymes aren’t strong enough.

Thanks for your response. It gives me something to try.

There is an on-line dosing calculator that makes it easier to determine the required amount of pancrealipase based on meal ingredients and the quantities. It does not yet list ZenPep so using the closest dosage to the Creon dosages in the menu will be equivalent.
http://digestthis.ca
Once I figured out the number of capsules for each meal, weight gain was much easier. Now I have to actually watch my weight in not gaining any more to maintain my BMI.

Thank you. I appreciate the information.

What is Zenpep like I just had a blood test and my liver is high and my doctor think it’s from the Creon I see the specialist in 2weeks Also my iron level is Realy high which is surprising as I don’t make iron and have an iron infusion every year My diarrhoea is still chronic have lost 9kgs in the last two months I watch what I eat as I am Diabities 2 controlled by diet but it has been in the 4lately which is unusual for me Have to wear nappies all day and night and my bladder gets urgent to

I was told to take two Creon capsules at Breakfast Lunch and Dinner and one morning and afternoon tea but if I only have a drink I don’t take it It says on the bottle 35,000 and 100 capsules All new to me

What you were told is an unscientific method and nothing more than a best guess. How to correctly dose pancrealipase has been an issue for a long time. The amount varies based on carbohydrates, fats and protein there is in a meal. Having dinner one night of a heaping mound of starch in a heavy Alfredo cream sauce, butter slathered on Italian bread and Tiramisu for dessert is going to take more Creon than a salad garnished with chicken. A bowl of Rice Krispies with banana and skim milk and toast is not going to take much-especially since the salivary glands in you upper neck region produce amylase and might be enough to handle a low fat meal.

I don’t need any Creon for my low-fat breakfast meals and don’t take in unnecessarily with what it costs for a bottle. This is why using the dosing calculator makes a lot more sense then someone generically saying to take X amount with meals and Y amount with snacks. And if one is eating fruits as a snack, fruits contain enzymes within them that get activated when it reaches your intestine. Enzymes are not required for fruits. That banana sitting on your counter in warm weather turning to mush is because of the enzymes within it breaking the fruit down into sugar.

Then there is the definition of “snack”. When a snack is more like a light meal of a sandwich and/or bowl of soup with meat and fat in it, then I’ll take one Creon. Otherwise I do fine with no Creon on what I consider a snack to be is something to hold me to meal time like a un-buttered roll or handful of crackers.

Some Registered Dietitians have a good understanding of how the pancreas works and how to correctly prescribe pancrealipase. Oncologists seem to have the least amount of experience in the correct use of pancrealipase and it’s understandable-they study hematology and oncology and treating solid tumors. It is the Registered Dietitians getting specific training. The ones with the designation C.S.O. Have the specific training in using pancrealipase and I still encounter many aR.D.’s not aware of the dosing calculator the Canadian Digestive Foundation created to simplify dosing to a more accurate way of doing it.

Excellent post….. makes a lot of sense. VERY HELPFUL!
Many thanks!!