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

If you still have symptoms or you are losing weight, speak to your dietitian, nurse or doctor. They can check if you are taking enough enzymes, and make sure that you are taking them properly. Some people need to change the brand of enzymes they take.

Sometimes, the doctor will give you medicines called proton pump inhibitors (PPIs). PPIs include omeprazole and lansoprazole. They stop the stomach from producing too much acid, which can affect how well the enzymes work. Usually, PPIs are tablets or capsules that are taken once or twice a day. Speak to your doctor about these medicines and ask if they would help.

It is not common to get side effects from enzymes, but some people get tummy pain, wind, or they may feel or be sick. These symptoms are often caused by the dose of enzymes being too low, rather than a side effect of the enzymes.

Increasing the dose may help. Try keeping a food diary for a few days to see what dose helps. Or your doctor may need to change the brand of enzymes you take.

Some people may have constipation (when you find it harder to poo). There could be many reasons for constipation. If you had runny poo before because of digestion problems, taking PERT may stop this, and you might feel constipated. Other medicines, such as opioid painkillers, can cause constipation. You may need a medicine called a laxative if you take opioids.

If you have constipation, speak to your doctor or nurse. They can work out what’s causing it and how to manage it. Do not stop taking your PERT.

If you have any questions about how to take enzymes, speak to your medical team.

• If you have not been prescribed PERT and have any digestion symptoms, ask your doctor, dietitian or nurse about it.
• Take more PERT if you still have symptoms.
• Keep a diary of what you eat and how much PERT you take each time. This will help you find the right dose for different foods.
• If you have any questions about how to take PERT, get in touch with our specialist nurses on our Support Line.
• Tell your dietitian, nurse or doctor if you are still getting symptoms even when you are taking PERT. There may be another cause, which they can help you with.