Does anyone have EPI (Exocrine Pancreatic Insufficiency)?
The prescription enzyme I take is 368.00 a month copay. Without insurance it is over 2000.00 a month! I’m looking for an affordable over the counter pancreatic enzyme with comparable lipase dosage of 40,000 units. I would appreciate any suggestions, as the diarrhea caused by this condition is intolerable.
Interested in more discussions like this? Go to the Digestive Health Support Group.
There is an organization for people with pancreatitis , mission-cure.org. I just watched the webinar by a nutritionist that specializes in pancreatitis on their site about so many things diet related and she went very in depth into the do's and don'ts on how best to be taking the enzymes. It was so helpful! I highly recommend you check out their website.
Hello,
I was diagnosed with EPI in 2023 and began the typical Pancreatic Enzyme Replacement Therapy (Creon). I went through several different diagnoses before being sent to a gastroenterologist and having blood work and fecal samples taken. I have more or less managed my EPI since then; however, I have frequent episodes of extremely foul smelling gas. I have also noticed that I have extremely irregular bowel movements, and these are almost always fairly loose.
What are your experiences with EPI? How do you manage the condition? Are there PERT options available besides Creon?
I have also recently started experiencing episodes of shortness of breath, followed by profuse sweating and abdominal pain that feels like severe bloating. When this happens I will typically lay down and begin to cool off, and after a few hours I will be able to either burp or pass gas and feel better in my abdominal region. A friend just told me about POTS and I have done some reading on the condition. I have not been diagnosed with this yet, nor have I seen a medical professional about it. From my reading, it seems that Pancreatitis, EPI, Gastroparesis, and POTS are all somewhat interconnected.
For those with Pancreatitis or EPI, have you found yourself being diagnosed with or experiencing symptoms of POTS? What do you do to manage your episodes? Have you also had problems related to Gastroparesis?
Thank you in advance for any information you can share with me!!
Hi, @psnead, and welcome to Mayo Clinic Connect. You'll see I've moved your post here to where others are talking about exocrine pancreatic insufficiency (EPI) so you can connect with others talking about that topic such as @cc8 @delilady @coooldad @yanina @agikam and others.
- Does anyone have EPI (Exocrine Pancreatic Insufficiency)?
https://connect.mayoclinic.org/discussion/does-anyone-have-epi-exocrine-pancreatic-insufficiency/
Hoping they have input to share on experiences with EPI and managing it, and options beyond pancrelipase (Creon).
Also, psnead, you might check out these discussions on Connect about POTS:
- I have symptoms similar to POTS but was told it isn’t POTS https://connect.mayoclinic.org/discussion/i-have-symptoms-similar-to-pots-but-was-told-it-isnt-pots/
- POTS https://connect.mayoclinic.org/discussion/pots-4/
Have you noticed any patterns for when you experience foul smelling gas or loose stools, psnead?
Hi
I have the EPI which requires Creon - expensive. In addition to that, I have developed SIBO (small Intestinal Bacteria Overgrowth. I think the two are related, with the SIBO creating the problem of constipation, diarrhea and lots of gas. That leads to trying to defeat the SIBO problem with expensive antibiotics. The antibiotics fixes the problem in the short run, but it comes back. I have not found a long term solution and I’m trying to work through fighting the SIBO. Sorry but I don’t have a good solution for you. There are other other enzymes pills etc but they are very weak compared to what I need for the EPI, thus I’m still on Creon.
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How do you manage the condition?
Each person finds a personal set of workarounds based on the symptoms, IMHO
In my case:
- Uncoated enzymes for pain and coated for deficiencies (more here https://www.youtube.com/watch?v=AlazwiXRjY0&ab_channel=Mission%3ACure )
- Home-made food only with comprehensive recipes/ingredients to manage constipations/type 2 diabetes (low carbs in my case, which is not advisable for kidneys and pancreatitis itself tbh)
- 2 hours of exercising after a meal (keeps me away from glucose spikes)
- Intermittent fasting (or no snacking, I should say ) to stay in moderate ketosis (keeps me away from hypoglycemia and gives the pancreas a rest)
- NTD + T3 to boost up metabolism a bit (helps with constipation and gastroparesis)
Managing my health is a full-time job for me now lol
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Are there PERT options available besides Creon?
FDA-approved:
Creon
Pancreaze
Zenpep
Ultresa
Viokace
Pertze
Source ( thank you @cc8 for sharing!!! ) https://mission-cure.org/managing-pancreatitis/pancreatic-enzyme-replacement-therapy/#elementor-toc__heading-anchor-4
Plenty of non-FDA-approved from:
+ Metagenics, Biotics, Pure, etc
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From my reading, it seems that Pancreatitis, EPI, Gastroparesis, and POTS are all somewhat interconnected.
100% + a bunch of other diagnoses as a consequence when one of the vital hormone-secreting organs is damaged and not performing its exocrine and endocrine functions
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Have you found yourself being diagnosed with or experiencing symptoms of POTS?
Funny, I never correlated my symptoms to it
Always attributed it to the low blood pressure, neuropathy, etc but POTS, thanks for sharing..
It's like umbrella diagnosis, tho
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What do you do to manage your episodes?
So, with a damaged pancreas, you wouldn't have enough bicarbonates
(The pancreas secretes bicarbonate (HCO3-), which is crucial for neutralizing the acidic chyme that enters the small intestine from the stomach.
In my case, I also have a bile reflux (or duodenogastric reflux) when bile contents go back up into the stomach
So I am finding a balance between taking external bicarbonate (electrolytes) and vigorous jumping with taps on my back to pass all the gases and burps
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Have you also had problems related to Gastroparesis?
From my experience, the suggested low-fat diet for pancreatitis is not optimal long-term
During the acute stage it's helpful, but once the pancreas heals, I would introduce a small amount of fats back slowly with PERT.
Otherwise, the bile is not gonna flow
- hence delayed stomach emptying, SIBO
- hence liver detox is not gonna work which, in turn, causing other problems with cholecystitis/stones
- hence constipation and nutrient deficiencies
- etc.
It can be a spoon of MTC added to your coffee or Omega oil after steamed broccoli, so on..
There are very few cardiologist interested in POTS. Few have tilt tables to test on. With long Covid I am getting more patients that I suspect have POTS. Even in L.A. I only have a handful of interested C.V. Groups willing to take on these challenging cases.
I think I might have SIBO as well. I’ve been doing some research for it, and it looks like oil of oregano is as effective as antibiotics, and in some cases more effective. Have you ever tried that? I haven’t been diagnosed with it officially, but I’m almost positive that’s what I have. Apparently the oil is quite strong and you’re supposed to be under a doctor’s care when you use it and make sure you get the right kind of course, but it sounds intriguing to me. Good luck.
I have this & am taking a new drug called Creon that has really helped me. However, it is very expensive, so had to apply for assistance from Angie , which I got. Really helps.
Have you ever tried oil of oregano for your SIBO? I think I have that, but I’m not sure, and I’ve been looking up remedies for it because I don’t like to take antibiotics. Just a thought. Good luck.
Hi, @sunshine29 - thanks for sharing your experience with pancrelipase (Creon). Are you saying you applied for and received assistance from AbbVie, the manufacturer of this medication?