New to exocrine pancreatic insufficiency (EPI): What helps?

Posted by jewill @jewill, Dec 6, 2016

I was dignosed with e p i. Exocrine pancreatic insuffency in 2015 after having a severe reaction to premarin estergen cream then 2 weeks later i had an even more sever reaction to an infusion of reclast it is a biphosphonates l am severly allergic to phosphates, dr did not check for that. i had diarrhea lost 20 lbs destroyed 90 % of my pancreas dr gave me creon 3600 2 with each meal low fat diet that is all the information i got from him did research on web for diet and supplments .need a dr in austin tx that knows more about e p i would apprecate any info on this thank you jewill

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Profile picture for mari @mari

Creon sounds like the really Expensive drug.$$$

I take VITAL supplements.
Take a small bite then Vital then eat.
Now I don't need 3 XS a day anymore. It depends on the type of food 'm going to eat.

My pancreatic insufficiency is much better now.

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Good to know but I am 71 years old and Medicare pays 100% of the cost of Creon. I’m glad you found an affordable and helpful alternative.

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Profile picture for tslayden @tslayden

Good to know but I am 71 years old and Medicare pays 100% of the cost of Creon. I’m glad you found an affordable and helpful alternative.

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wow! this means your Pt D or Medicare Advantage plan pays for creon in full. I'm in PA and just going on Medicare and a supplemental plan this year, looking forward to better coverage for creon and realize I have different choices in different states, but out of curiosity, which health insurance company do you have?
I priced VITAL after reading the post, but it would be too expensive compared to my current price for creon.

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Profile picture for dianehrdr @dianehrdr

wow! this means your Pt D or Medicare Advantage plan pays for creon in full. I'm in PA and just going on Medicare and a supplemental plan this year, looking forward to better coverage for creon and realize I have different choices in different states, but out of curiosity, which health insurance company do you have?
I priced VITAL after reading the post, but it would be too expensive compared to my current price for creon.

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My Medicare plan is not an adantage plan and is through Aetna. I have a secondary plan through Physician’s Mutual.

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I am new to EPI as well with no known cause. I have two CT scans and everything comes back okay. The creon had helped for awhile but no one had ever talked to me about my diet. I am so over senstative about my health and get concerned when I lose a few pounds and I know I need to. I just what the loose bowel movements to stop. Test after test test and no one is finding anything. Bills are piling up from the test. I have recently started Lexapro not sure if that is related. I do get an pain right in the center of my chest but never on either side. Blood test come back mostly okay and I had a little higher than normal blood protein but the two value are in check. Waiting on results for the rerun as it may have been stressed induced.

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Profile picture for mari @mari

Creon sounds like the really Expensive drug.$$$

I take VITAL supplements.
Take a small bite then Vital then eat.
Now I don't need 3 XS a day anymore. It depends on the type of food 'm going to eat.

My pancreatic insufficiency is much better now.

Jump to this post

Is there a specific VITAL supplement? How long has this been working for you? On CREON, but worried I can't get it outside of North America as a foreigner, supply chain, the overall cost, etc. Looking for alternatives.
Did you do testing after starting the supplements to see if there is a measured improvement? Or is it the symptoms that improved, or both?
Apologies for all the questions. EPI results in exhaustion, and occasionally, I have very IBS - D that disrupts my life, so I am always hesitant to change course too quickly. Having said that, dealing with my life now that it focuses on access to Creon is frustrating.

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Profile picture for dianehrdr @dianehrdr

thank you very much for your input. I will look into Colestid. I too, lost a lot of weight, was malnourished, particularly in the beginning but repeatedly during bouts of SIBO or loss of appetite/diarrhea.
Gosh, it is really is interesting because I started being symptomatic after Covid in 2020 and not one doc has acknowledged that this may be the cause. I feel I have been viewed as an alcoholic or whatever they have perceived ahead of time, so this is refreshing to know in your case.
I am wondering if this is becoming a more frequent diagnosis since Covid hit the scene.
Also, may prompt more research.
My big question...is it worth my travel/flight/hotel/cost/fatique to travel to the Mayo Clinic or is this really a condition of strict management, mostly on our own?

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Your input is very interesting to me. I have been diagnosed with EPI, previously SIBO, Ileocecal valve issues and IBS after Hiatal Hernia surgery.
I have been the thinking of going to Mayo Clinic as well, and wonder if these are all "live with it" issues. I have been on Creon, now on Zenpep, still having diarrhea issues, for over 2 years. Suggestions , anyone? Thank you.

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Profile picture for tslayden @tslayden

My Medicare plan is not an adantage plan and is through Aetna. I have a secondary plan through Physician’s Mutual.

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Also my Medicare Part D plan is Wellcare Value Script, which I chose after listing all of my meds and comparing plans.

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I just wanted to add that despite taking Creon for several months I still have IBS-D with no discernible change. I have not been retested for the pancreatic insufficiency since starting the Creon.

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Profile picture for tslayden @tslayden

I just wanted to add that despite taking Creon for several months I still have IBS-D with no discernible change. I have not been retested for the pancreatic insufficiency since starting the Creon.

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Perhaps you need a different dosage? A consultation with a dietitian? I take peppermint oil (sold at CVS as Intestinal Defense...the CVS brand). A low FODMAP diet also did wonders for that for me. There are still issues with IBS-D symptoms but it is better. Good luck.

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Profile picture for creondave @creondave

Perhaps you need a different dosage? A consultation with a dietitian? I take peppermint oil (sold at CVS as Intestinal Defense...the CVS brand). A low FODMAP diet also did wonders for that for me. There are still issues with IBS-D symptoms but it is better. Good luck.

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A bariatric dietition is who prescribed the Creon. But I may need a different dose. I have been thinking about a low Fodmap diet, maybe I will try it. I do drink peppermint tea but have not tried peppermint oil—how much do you take? I rely a lot on immodium.

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