Editing Pancreatic nutritional disease (section)

== Therapy ==

* Either Creon or Panzytrat
* Creon is a porcine pancreatic enzyme extract (contains lipase, amylase and protease)
** Half-life only 20 minutes - take the Creon with your first bite, and may need another dose if having a long meal
* Panzytrat is also porcine, just slightly different make-up of enzymes
* Dosing - 25,000 to 40,000 units with each meal. Can be titrated up to a maximum of 80,000 units per meal (more than that is very expensive and shouldn't be needed - something else is going wrong if you need that much).
** If reported inadequate response to therapy, check compliance via measurement of faecal chymotrypsin? In the compliant patient, double or triple doses, and check for other causes of malnutrition. Consider trying concurrent PPI. Consider coeliac disease, bacterial overgrowth, blind loop syndrome, giardiasis.
* Give a 6-week trial of treatment, if starting Creon