I dx'd myself with EPI after accidentally happening upon a podcast meant for gastroenterologists. I then told my GI doc that I ticked all the boxes for EPI and she agreed to have me try out Zenpep (samples), which worked immediately! With Medicare and my insurance, I have to go through 30 days of taking the successively more expensive drug before they will cover Zenpep. I'm currently on my fourth one and the problem has gotten worse, mainly the severe pain after ingesting ANYthing; so I skip eating for a day or two to allow my digestive system to calm down. Yes, I take the meds with snacks/meals, and sometimes I'm able to eat a meal without pain every few days or so. My main problem is that my labs have always shown false negatives (one of my sons has the same problem) and I've rarely had a doctor or nurse practitioner who was wise enough to treat my symptoms rather than taking the lab results as the have-all, be-all.