It took a year after total distal pancreatectomy and splenectomy to convince my doc's I needed PERT, I had tried PERT in the past prior to surgery, but they decided it is overprescribed and took me off it. I didn't respond well to Creon, and I do well on Zenpep, so they put me back on Zenpep, I don't have those side effects you mentioned. The GI symptoms have subsided thank goodness which was the goal. I did find this though...

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Rare Side Effects of Zenpep (Pancrelipase)
Rare but serious side effects of Zenpep include fibrosing colonopathy, severe allergic reactions (including anaphylaxis), and hyperuricemia (high uric acid levels)
Key Rare Adverse Effects
1. Fibrosing Colonopathy
A rare, potentially serious bowel disorder linked to pancrelipase.
Symptoms: severe abdominal pain, trouble passing stool, nausea, vomiting
Requires urgent medical evaluation; immediate treatment may be needed.
2. Severe Allergic Reactions
Can include anaphylaxis, a life‑threatening reaction.
Signs: rash, itching, hives, swelling of hands/face/mouth/throat, hoarseness, trouble breathing or swallowing
Call your doctor or go to ER immediately if these occur.
3. Hyperuricemia (High Uric Acid)
Pancrelipase may increase uric acid, leading to joint pain, stiffness, swelling, or back/side pain
Seek medical advice if you develop these symptoms.
4. Mouth Irritation
Rarely, capsules may cause irritation if not swallowed whole, crushed, chewed, or mixed into inappropriate foods
Prevent by following dosing instructions exactly.
When to Seek Medical Help
Contact your healthcare provider or seek emergency care if you experience:
Severe or persistent abdominal pain, especially with bowel changes
Signs of allergic reaction or breathing difficulty
Joint pain, swelling, or stiffness
Prevention Tips
Swallow capsules whole with water unless your doctor instructs otherwise
Avoid inhaling powder if mixing capsules into food
Bottom line: While most Zenpep side effects are mild, rare but serious reactions exist. Prompt recognition and treatment are key — report any unusual or severe symptoms to your doctor right away.