Anyone tried over the counter enzymes to help digest fat post whipple?

Good morning. I am eight weeks out from having the Whipple. I am taking pancreatic enzymes. I had started them prior to surgery, while on Folfirinox. The clinic nutritionist ordered a fecal test that was the basis for the prescription and dose. I am just starting up on Folfirinox again—I had eight rounds prior to Mr. Whipple and intend to have four more

There are five FDA approved brands of pancreatic enzymes and there are three different enzymes in a capsule. I had been taking Creon, spending over $500/mo—I have Medicare and am in the donut hole. Another brand is Zenpep and there is a financial assistance program offered by the maker, Nestlé. I applied with the help of my oncology clinic and was approved. So I will get Zenpep through 2024 for free. The Creon website has a link to a program that can provide financial assistance.

The nutritionist also mentioned over the counter enzymes. I checked them out and realized that the ratio of the three enzymes is quite different from FDA approved enzymes. In addition, the dosage is significantly less per capsule, meaning I would have to take nine capsules with each meal. That meant I would have to purchase a lot and it would be a bit of a hassle.

In short, the OTC enzymes may have a different mix of the three pancreatic enzymes and the amount per capsule will likely be quite less than the FDA approved.

I pushed send too quickly. I would suggest talking to your doctor if you haven’t already. That might lead to testing your digestion and a prescription—my plan covered Creon and was willing to cover Zenpep. My out-of-pocket expense would have been significantly less than the $500 if I wasn’t in the donut hole and there are financial assistance programs available.

There is a virtual seminar tomorrow on EATING & NUTRITION w/PANCREATIC CANCER. It features a very well known Dietician with Atlanta Liver & Pancreas Surgical Specialists. She has a background in GI oncology and now works exclusively with Liver and Pancreas patients. I highly recommend her! Seminar is free. Register here.

Thank you for this information. I have registered and will attend.

Was this recorded do you know? I wanted to watch it and can’t get any information off the site.

I had the Whipple in April of 2023. I do take Creon. It is expensive but the manufacturer, Abbvie, does have financial assistance programs. Even with the Creon (96,000 units), I still can not digest animal fats.

Thank you for your reply. After the attending the EATING & NUTRITION w/PANCREATIC CANCER seminar, I called my Dr. He has just put in the script for Creon. I should get it in a few days. We are starting on the low end 24,000 units. We may increase the dosage based on how things go. As was stated in the webinar, what concerns me about the over the counter enzyme supplement is the filler they use. Since this is not regulated, one doesn't really know what is in the capsules with the enzymes. That makes me nervous.

Yes. The recording will be made available soon I’m sure. There is also an excellent recorded seminar on pancreatic cancer there as well.

Great info, @jeeplewis. How is recovery going? When do you start chemo again?

I think that my symptoms are actually being controlled more successfully since I have been taking 36,000 units three before meals and snacks, this is currently four times daily. When I started to get out into the world again, even gas is really an issue since it is not socially acceptable.