I just got a call from gastrologist office. They did a stool sample and it shows have pancreatic insufficiency!! I have to pick up a drug called Zenpep and take before each meal. Jan what do you think? I also have chronic pouchitis.

Thanks

Gmarie

Hmmm.... My only concern would be missing another diagnosis, since a deficiency of pancreatic enzymes is generally associated with pancreatitis, cystic fibrosis or Celiac disease, or even diabetes.

If these have been ruled out or have been diagnosed, then I think it is fine to just treat with digestive enzymes. Here is the link to the product information if you are interested:
http://www.zenpep.com/site/cfhcp.aspx

Perhaps this is the cause of your pouchitis too.

Jan

Thanks for your quick reply. Could all of the off and on pain I have after eating but not every day (usually in the pm) upper abdominal and back pain be pancreatitis. I just assumed it was adhesions, partial blockage or my chronic pouchitis. I have lots of watery diarrhea that is yellowish. Like most of us I just suck up pain (my pain tolerance has gotten huge over the years) that folks with our issues would be running to the ER with. Should I just tke the enzymes for awhile first? What other tests should I ask gastrologist to do? The have had several small gallstonesI developed after j-pouch surgery. It never ends.

Your symptoms could easily be from malabsorption due to pancreatic insufficiency. Blood tests could rule out pancreatitis, but your pancreatic damage could have happened in the past and there is no ongoing inflammation in the pancreas now. So, yes it does make sense to go ahead and take the enzymes and see what they do for you.

But, my real question to the GI doc would be WHY do you have pancreatic insufficiency? The insufficiency is a sign of some other disorder. Sure, you can take the enzymes and if they solve your problem, not inquire further. But, if you have a progressive disease, wouldn't it make sense to get to the bottom of it and treat that too?

For example, what if you have celiac disease and should be avoiding gluten, but miss the diagnosis because you are treating the pancreatic insufficiency. If you keep eating gluten, then more and more of your small intestine will be damaged, and you will require more and more enzymes to absorb nutrients until your gut is not working at all.

Sure this may be self limiting and not progressive, but I would want to know one way or the other what the underlying condition was.
http://www.sutterhealth.org/he...?A=C&hwid=hn-1052003

Jan