Creon - am I taking too much or too little?

Posted by stillaround @stillaround, Sep 27, 2025

Hi - pancreatic cancer person here. (Surgery 14 years ago removed tail, recurrence on head a year ago, currently in remission after treatment including hi-dose radiation.) Started Creon several weeks ago. I THINK I am taking enough as I am finally putting weight on, stools are proper color etc. But I am quite bloated with distended belly and a bit constipated. If everything else is good could this mean I'm not taking enough? Or does constipation with normal stools mean I'm already taking too much?

I take 36,000 with my smallish calorie-dense meals, my weight is 108. The PERT calculator indicates I need closer to 48,000 at breakfast but other meals I'm in range.

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Profile picture for Turkey, Volunteer Mentor @tomrennie

@valerina30 Good luck with the results of the cat scan. Any idea on when you might get them?

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@tomrennie tommrow I should.

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Profile picture for artistrose @artistrose

@valerina30 The fecal elastase test is a “stool” test. It is ordered by a doctor and done by a lab. It’s purpose is to test your stool for pancreatic insufficiency. Depending on the number you get for pancreatic insufficiency, depends on how much Creon (or other brand enzyme) you need. After the test my doctor prescribed me 2-24,000 units of Creon per meal. However, my EPI number is in the moderate, not severe range. Those in severe range would have higher doses. Your weight also figures into the calculation.Either a GI doctor or dietician should be able to help you. Hope this helps.

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@artistrose Thank You I’m gonna ask my doctor for one.

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Profile picture for valerina30 @valerina30

@artistrose Thank You I’m gonna ask my doctor for one.

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@valerina30 According to Medline: If you are taking pancreatic enzyme supplements, you may need to stop taking them for five days before the test. Don't stop taking any medicines unless your provider tells you to.

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Profile picture for artistrose @artistrose

@valerina30 According to Medline: If you are taking pancreatic enzyme supplements, you may need to stop taking them for five days before the test. Don't stop taking any medicines unless your provider tells you to.

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@artistrose ok Thanks for the heads up!

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16 months creon taker after a Whipple. Yes, it is trial and error. I take 3 creon 25000 for a major meal and 1 if just a light meal eg a nut bar or toast. It has taken ages to get to the point of no urgency to go to the toilet. Slightly delayed now but hoping to negotiate a better regime for outing safety sake. If you don't take enough creon as I understand it, then valuable nutrients are not being absorbed for best health and subject to weight loss.

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Someone mentioned 'dumping' . Is that letting all the sheep out in one sitting. Like completely emptying the bowel after a compulsory 15 minute sit. Whipple and creon is a whole new world of pooping. Guess I just want to know what is normal after Whipple and creon. Thank you for sharing your experience 😊

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Agree. Difficult to get the right dose. I still don’t understand why Creon cause gas and abdomen bloating. Even with Plain Diet
Any suggestions

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Profile picture for margaretbannan1948 @margaretbannan1948

Someone mentioned 'dumping' . Is that letting all the sheep out in one sitting. Like completely emptying the bowel after a compulsory 15 minute sit. Whipple and creon is a whole new world of pooping. Guess I just want to know what is normal after Whipple and creon. Thank you for sharing your experience 😊

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@margaretbannan1948
Dumping refers to the stomach emptying food all at once or too fast into the small intestine. I don’t have it, so I don’t know much about it, but it doesn’t sound like a good thing. I hope that helps.

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Profile picture for whipple123 @whipple123

Agree. Difficult to get the right dose. I still don’t understand why Creon cause gas and abdomen bloating. Even with Plain Diet
Any suggestions

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@whipple123
I take Beano, which is an over the counter enzyme, with my Creon and it helps me, especially with veggies. It may help you, too.

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Profile picture for whipple123 @whipple123

Agree. Difficult to get the right dose. I still don’t understand why Creon cause gas and abdomen bloating. Even with Plain Diet
Any suggestions

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@whipple123 To optimize the dosage of Creon specific to the amount of carbohydrates, protein and fats in the meal, use the on-line dosing calculator at: pertcalculator.org

Take the first capsule at the start of the meal with food. Take additional capsules as calculated staggered throughout the meal.

If you et high fiber vegetables and legumes, pancrealipase does not contain the enzyme alpha-d-galactosidase needed to digest these oligosacchride-containing foods. The OTC product BEANO is the enzyme alpha-d-galactosidase and will digest high-fiber foods without the formation of gas or bloating.

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