Does anyone have EPI (Exocrine Pancreatic Insufficiency)?

While all the OTC and Rx pancrealipase are sourced from porcine pancreas, the Rx brands use enteric coatings to control the time release of the microspheres of the amylase, lipase and protease. This is how the capsule contents provides coverage over 45 minutes. Non-enteric coated enzyme brands get activated immediately upon reaching the alkaline pH of the intestine and lose their activity after 15 minutes.

As was already pointed out in another post of this thread, manufactures use different units for reporting the enzyme concentration of lipase. The Rx brands tend to have a higher lipase concentration than the OTC counterpart.

Another difference is in order to have FDA approval, the Rx brands must meet or exceed rigid quality control standards including adhering to a tighter tolerance in variability of enzyme activity published on the label. Variation from what is published must be within +/- 10%. This adds manufacturing costs for adhering to FDA manufacturing guidelines.

The variability is a much wider range in OTC brands. This would be important with infants and adults following a limited, consistent diet where dosing is more critical.

Diagnosed with EPI. Taking Creon 36000. 3 every meal for about 2 months. Have not seen any improvement. I see a Gastro doctor. Any advice on a second opinion to see a Pancreatic specialist at the Mayo in Rochester Mn. I live in the South. A long way away.

RJ Coach, Do you know what your elastase level was? The lower it is, it would make sense the higher the dose of Creon you need. There’s also a possibility that you might have another digestive problem like Bile Acid or a coexisting food intolerance like gluten or lactose contributing to the problem. I would ask your GI dr to consider and test for any other issues that could cause your symptoms if that hasn’t already been done. Good luck and let us know what you find out please. We are all learning from one another here. Since you live in the south have you considered Mayo in FL or AZ?

I am very fortunate as I now get my digestive enzymes prescribed from my doctor and insurance covers them.
I get triple what I need. Anyone taking Creon prescribed? Or in need? Any issues for those of you who take it?

I started out taking 11 creon a day in 2017 after diagnosis of EPI. I learned to stay away from lettuce and dairy foods. Carbs do well. I still have problems from time to time but I hardly ever take creon now. I hope you can learn to cope with this disease. It may get better.

I have gathered I formation from NP at GI office as well as dietitian. Plus I follow a EPI dietitian on FB who is very knowledgeable in this area. I also follow a EPI support group on FB. Many folks in this group have had EPI for years and share their experiences. Read various articles from reputable sources. The more you educate yourself the better you are at advocating and helping manage the condition.