@lisalucier
My gastroenterologist approved the substitution but recommended I take the Zenpep when necessary (eating a Wagyu steak for example… which I would never do!)
Another recommendation made by both the doctor and the dietitian was to take a pill just before eating and to take another one about halfway through the meal. That recommendation has worked quite well with the enzymes. The dietitian had recommended Pure Encapsulations. I did a lot of research on my own - there are a lot of enzymes out there, but my Gastroenterologist agreed that these are very high-quality, in fact he recommended their vitamins too. It has taken years to get to the point where I feel like I am managing this extremely well now. Hyper awareness of what the triggering foods are and what the timing is has really helped.