Pancreatic Enzyme ReplacementFunctioning of the pancreas can be compromised in CF if the pancreas ducts become clogged, blocking the delivery of the digestive enzymes that the pancreas generates and secretes. If the enzymes are blocked, they do not reach the food in the small intestines, which can lead to poor digestion and absorption, as well as problems with weight gain.
Fortunately, pancreatic enzymes replacements or "enzymes" are available to help people with CF digest and absorb their food. Replacement enzymes generally come in capsules containing beads with a special "enteric coating" that allows them to dissolve in the small intestine, where they promote nutrient absorption and proper digestion.
Enzyme capsules should be taken just before meals and snacks. Adults and older children can swallow the capsules whole with liquid, but for small children and infants, capsules should be opened and the beads mixed with soft food, such as applesauce.
If a baby spits out the beads, continue feeding the bead mixture until it is all swallowed. The enzymes do not have a taste, but the child may take time to adjust to the texture. If your baby continues to struggle with the enzymes, you can call your CF dietitian or care center.
Signs of Enzyme Maldigestion and Malabsorption
The following are symptoms of inadequate enzyme activity. Patients who receive enzyme replacement and experience these symptoms may need to adjust their dose or the type of enzymes they use.
General Information About EnzymesThe FDA has required all pancreatic enzyme manufactures to undergo testing and approval for their formulations, and set April 28, 2010 as the deadline. So far, three brand pancreatic enzymes have met the new rigorous requirements set by the FDA and have been approved. These are Creon, Zenpep and Panceaze. For more information on pancreatic enzyme treatment, click here.
Foods That Do Not Require EnzymesFoods that contain only simple carbohydrates do not require replacement enzymes to digest. You can consume any of the following foods without enzymes: