share your information about pancreatic enzymes

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sweetninis

New member
Hi all

I am a mother of a 10 months old CF daughter.These days I have been wondering so much about PE(pancreatic enzymes)how they suggest units.what does it contain.and also things you should keep in your mind while u give PE to ur child. my daughter takes 4 capsules of creon of 2500 units.How much your child use to take at 10 months of age? Plz share any videos or links of articles on PE here if u know of any

THANKS
 
R

Ratatosk

Administrator
Staff member
DS was on a different enzyme when he was that age. He was on Pacrease MT-4s and he took 3 1/2 capsules with most meals. Depended a lot on output. As he ate more, he needed more enzymes -- if they were very loose then we needed to look at gradually increasing his enzymes by about half a capsule. Today he takes 4-5 creon 12,000 capsules with snacks and about 7-8 with meals.
 
J

just1more

New member
sweetninis said:
Hi all

I am a mother of a 10 months old CF daughter.These days I have been wondering so much about PE(pancreatic enzymes)how they suggest units.what does it contain.and also things you should keep in your mind while u give PE to ur child. my daughter takes 4 capsules of creon of 2500 units.How much your child use to take at 10 months of age? Plz share any videos or links of articles on PE here if u know of any

THANKS
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As for dosing, follow the suggestions of your CF doctor, or the nutritionist at the clinic. Over time you well develop a sense for how to judge need. Meals tend to be a set amount, snacks get a trickier, especially as they get older and can self feed. As she grows you will increase enzymes based upon 1) how her body/stools are responding and 2) the size and/or amount of fat in the meals.

As for contents. Creon (and most other CF enzymes) contain 3 enzymes that are made in the pancrease normally and then delivered to the small intestines just below the stomach to aid in digestion. The 3 and what they break down are: Amylase (carbs), Protease (protein), Lipase (fat). The dosing is normally based upon Lipase, as fat digestion can be measured in a lab test and thus you can see how they are working. Thus, Creon 2500, has 2500 units of Lipase per capsule. The proportions between brands vary slightly but Creon 3 (they reformulated last year to even #'s so I'm not sure if she is on 2500 or 3000) has: L-3000, P-9500, A-15,000 just so you have an idea.

As for keeping in mind....not 100% sure what you are looking for. If it is risks, the primary is that if you give WAY too many it can lead to a bowel obstruction. But this would be like giving several times the prescribed dose, not something that would happen accidentally. Beyond that, they are just part of life with CF. You will get so accustomed to them that they become second nature and they will start to find homes in random places like your purse as you never knew when they might decide to eat and the worst feeling was to be out somewhere and discover you want to stop for ice cream and not have enzymes.

If you have more questions, just ask. This is a learning process.
 
6

65rosessamurai

Guest
just1more had summed it up pretty well. Especially for a 10 month old, go by the doctor's suggestions, but pay attention to what foods react and how. Also would be to pay attention to weight gain/loss and the type/quantity of stools. (I know, not a pretty sight, but imperative).
Using this information to take to the next visit may change the dosage, and as just1more had wrote, as your child grows, adjustments will be made, usually based on becoming accustomed to the dosages.

In respect to the dosages and the type of enzymes, other manufacturers have different dosage levels, but they all have the same three ingredients.

And, finally, if you have more questions, feel free to ask...
 
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sweetninis

New member
How long Does the enzymes remain in the stomach.if I give her enzymes with food at 7 with 100 ml of food and then at 8 she feels hungary again
I give her 50 ml of rice puree would the enzymes digest it or another creon has to be given
 
R

Ratatosk

Administrator
Staff member
If it's been an hour since she's been given enzymes and you feed her again, she'll need more enzymes. DS drives me nuts because he can snack all day and some weekends I feel as if I'm just handing him enzymes every half hour 'cuz he's eating constantly.

Are you talking about what to give her, her enzymes with? We always used babyfood bananas or pears. Dairy can break down the enzymes, so we never used yogurt to feed them to ds. If you're talking about feeding her just plain rice puree, then she probably doesn't need much in terms of enzymes unless she's VERY pancreatic insufficient and pretty much needs them for everything. DS is usually okay with small amounts of no fat items such as pretzels or fruit snacks.
 
P

Printer

Active member
I have to take half of my enzymes (10 Creon 24) at the beginning of my meal and the balance upon completion. When I was younger and still had some pancreatitic function, I could skip my enzymes occasionally for one meal. Now, I have to take enzymes with as little as one cookie.

The answer to your question is dependent upon the amount of enzymes that her pancreatis is still naturally producing. I have been told that all of the enzymes are "gone" in 45 minutes. If the meals, or snacks were an hour apart, I would repete the enzymes.

Bill
 
S

sweetninis

New member
@RATATOSK

Please let me know what do u mean when u said dairy will break down the enzymes do u mean dairy products like milk etc consume more enzyme?
My cf dr has told me to give her creon 2500 every 8 hourly that makes 3 capsules a day.She is eating potato and rice and lentil puree finely blend and just that and she is eating upto 600 ml a day she is 6kg at 10 months of age do u think she is taking enough enzymes
 
R

Ratatosk

Administrator
Staff member
http://www.cff.org/UploadedFiles/Li...t/Nutrition-Pancreatic-Enzyme-Replacement.pdf

Enzymes aren't something you just take every few hours like an antibiotic or pain reliever, but something that needs to be taken anytime food with fat or protein is consumed. Not Every 8 hours!!! I'd check the link above or the CFF site for more info. With DS I'd sprinkle enzyme beeds onto a spoonful of pureed fruit and proceed to feed him his bottle or yogurt or stew. If he ate an hour later, more enzymes. As for the dairy, it's my understanding in the short time that the enzyme beads sit in it on a spoonful, they can begin to break down much more quickly. You want them to make it thru the stomach and get into the small intestine to help your child break down the food.
 
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just1more

New member
sweetninis said:
@RATATOSK

Please let me know what do u mean when u said dairy will break down the enzymes do u mean dairy products like milk etc consume more enzyme?
My cf dr has told me to give her creon 2500 every 8 hourly that makes 3 capsules a day.She is eating potato and rice and lentil puree finely blend and just that and she is eating upto 600 ml a day she is 6kg at 10 months of age do u think she is taking enough enzymes
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May I ask where you live (country, nothing more detailed since we are online)?

Based upon this post it is pretty clear you are not in the US, and therefore I just want to let you know that you may see some differences between what most of us are used to and what your local physicians tell you. Not in how the drugs work, but in how they are prescribed. I have heard of the concept of giving enzymes on a schedule; and while different it is not necessarily wrong. If you are having concerns with weight gain or stools that are loose/oily, then I'd call your CF center. At 6kg/10 months she is well below the US growth chart and would be considered failure-to-thrive in the US (she would need to be ~7.5kg to not be considered 'at-risk').
 
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sweetninis

New member
I live in Pakistan its an underdeveloped country here cf ers doesnt have those facilities available as some good countries do have neither we have many good doctors here thats why i have to ask so many questions plz dont mind my asking
 
R

Ratatosk

Administrator
Staff member
sweetninis said:
I live in Pakistan its an underdeveloped country here cf ers doesnt have those facilities available as some good countries do have neither we have many good doctors here thats why i have to ask so many questions plz dont mind my asking
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I don't mind answering questions at all. Hopefully our answers are helping.
 
K

kitomd21

New member
Definitely pay attention to her stools as she gets older and starts to eat more varied foods. With respect to listening to your CF center - make sure you do your fair share of research. Ask questions here...you'll be surprised at how much variation there can be between centers. In the case of my daughter, her original CF nutritionist was underdosing her enzymes by 300%. We left that center! She hovered around the 3-11% weight:length (and they never pushed for a g-tube for whatever reason) then jumped up to 20%, then 60%, and is now above 90% with the care of the other center - without a feeding tube. Terrible.
 
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sweetninis

New member
kitomd21 said:
Definitely pay attention to her stools as she gets older and starts to eat more varied foods. With respect to listening to your CF center - make sure you do your fair share of research. Ask questions here...you'll be surprised at how much variation there can be between centers. In the case of my daughter, her original CF nutritionist was underdosing her enzymes by 300%. We left that center! She hovered around the 3-11% weight:length (and they never pushed for a g-tube for whatever reason) then jumped up to 20%, then 60%, and is now above 90% with the care of the other center - without a feeding tube. Terrible.
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could you plz tell what specifically we should look for in a stool of a cf child?
 
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