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What if pancreatic enzyme replacement therapy doesn’t help my symptoms?

Pancreatic enzyme replacement therapy (such as Creon®) replaces the enzymes that your pancreas would normally make. If you have pancreatic cancer, pancreatic enzyme replacement therapy can help you digest your food. This can help with symptoms such as weight loss, runny poo (diarrhoea) or losing your appetite.

Your dietitian, doctor or nurse can tell you how to work out the best dose of enzymes for you. They should review the dose regularly. Read more about working out the best dose of pancreatic enzymes for you.

How do I know if I am taking enough pancreatic enzymes?

If you are taking enough pancreatic enzymes, your symptoms should get better, and for some people the symptoms may go.

If you still have symptoms or you are losing weight, speak to your dietitian, nurse or doctor. They may increase the dose of enzymes. They may also look at whether anything else is causing your symptoms.

What if pancreatic enzymes don’t help?

If your symptoms don’t get better, speak to your doctor, nurse or dietitian. They can check if you are taking enough enzymes, and that you are taking them properly. Some people need to change the type of enzymes they are taking.

Sometimes, the doctor will give you medicines called proton pump inhibitors, that help the enzymes to work better. These include omeprazole and lansoprazole. These medicines stop the stomach from producing too much acid, which can affect how the enzymes work. Speak to your doctor about these medicines and if they would help.

Other causes of symptoms

If you are taking pancreatic enzymes and you still have symptoms, there may be other causes for these. For example, strong painkillers called opioids (such as morphine), antibiotics, or chemotherapy can all cause changes to your bowel habits.

If you have diarrhoea that isn’t getting better even after increasing your enzymes, you may need to have some tests to check what is causing the diarrhoea and how to manage it.

Speak to your medical team about your symptoms and what might be causing them.

Find more information on pancreatic enzymes

How do I take pancreatic enzymes?

What happens if i take too many enzymes?

Are there any side effects of enzyme supplements? 

Coping with diet symptoms

Diet tips for pancreatic cancer

Updated January 2020

Review date January 2023

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