To be clear, pancreatic insufficiency usually is exocrine insufficiency or EPI as doctors use the term when they wish to be clear whether they are referring to digestive enzyme production or insulin production, IPI, since endocrine pancreatic insufficiency would likely be the same acronym. Total Pancreatic Insufficiency is usually PI which is usually accompanied by diabetes. Alcohol consumption does damage that's nearly indistinguishable from the damage inflicted on the pancreas, liver and gallbladder by the ravages of CF. The metric is either rules for diabetics or drinking proportionally to the condition of the affected organs.
Alcohol causes islet cells and the liver work extra hard to metabolize and counter the effects of alcohol. The general advice that a glass of red wine or two drinks daily does depend on how healthy the liver and islet cells are. I am not opposed to alcohol in moderation but we may be working with compromised organs that should involve your doctor's advice. Growing up in Wyoming, drinking was thought of much like smoking except the decision when to start was set at 21. The adult social life was hitting two or three bars or lounges the evenings of Thursday, Friday and Saturday nights. This lasted about a year averaging about s drinks a week. I essentially stopped drinking with several exceptions each year and found a real problem in my thirties.
Business travel is difficult to be healthy and develop relationships. From the early 80's until 2000, I traveled domestically and internationally 50% of the time. I wore several hats, especially internationally where I had distributors, existing and potential customers. With the exception of service calls, everything except for breakfast was an opportunity and usually pressure to share in pitchers of beer or rice wine or Gruppa, Vodka ad infinitum. Fortunately most distributors were happy when I suggested we drop the requisite drinking and leave it individual choice.
I reached a point where the rare meals I'd drink a favorite local beer and then be very sick within minutes. It marked a point that alcohol and the state of my pancreas were at at impasse. I'm fairly certain that most CFers who have a compromised pancreas experience autodigestion to some degree. Pancreatic autodigestion is where digestive enzymes are produced but stick in the pancreas until the enzymes break down any protective mucus and partially digests the pancreas. Printer is being kind. The pain from pancreatitis, especially acute pancreatitis can exceed that child birth/kidney stone top pain comparison.
Gout and gouty arthritis pain is not trivial. Our use of enzymes predisposes us to gout and gouty arthritis. I can remember people my grandparent's age , born around 1900, tittering and snickering when gout was mentioned. It had been a disease of excess, rich foods, fine spirits and sweets. It was Puritan fodder and the conservative and pious had a field day with a condition that can be unbearably painful. And its not any character flaw that causes it. I wouldn't wish gout on my worst enemy.
It isn't the alcohol and enzymes. Mostly it's what remains of islet cells getting a workout. Diabetes has its own rules for alcohol and that is the primary concern. If a person is totally PI and the nerves aren't going nuts with pain, moderation is the rule. There's some valuable information contained in this topic post. It was just a couple months ago that gout and CF were mentioned in an article. It never occurred to me that alcohol for some CFers needs to be avoided.
Great topic,
LL
