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The pancreas is a gland in the body that makes enzymes to digest food. About 90% of people who suffer from CF also suffer from pancreatic insufficiency.1 The tubes in the pancreas become clogged with thick, sticky mucus, which blocks the enzymes from reaching the food in the small intestine. This makes it tough for the body to properly absorb and digest the nutrients needed to grow and maintain a healthy body weight. Pancreatic enzymes are available to help people with CF digest and absorb their food.2

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Where is the pancreas located?2

The pancreas is connected to the small intestine, located behind the stomach.

What do pancreatic enzymes look like? How do they work?2

Enteric-coated pancreatic enzymes come in capsule form. There are many small "beads" in each pill. These beads contain digestive pancreatic enzymes. Each bead has a special coating (called an enteric coating) that allows the bead to dissolve in the small intestine. Once dissolved, the pancreatic enzymes are released in the small intestine to help digest food.

Most pancreatic enzymes have an enteric coating. This means that the capsule is coated with a material that delays the release of the medication until the capsule has passed through the stomach. Once the capsule reaches the small intestine, the medication is released.3

Pancreatic enzymes have 3 main purposes2:

  • To digest carbohydrates, proteins, and fats (3 components of food that supply calories)
  • To help absorb nutrients
  • To help with weight gain

When and how do I take my enteric-coated pancreatic enzymes?2

  • Take pancreatic enzymes with all meals and snacks and as directed by your healthcare provider
  • Take pancreatic enzymes with a liquid and swallow pills whole
  • If you can't swallow pills whole, follow these steps:
    1. Open the pill up.
    2. Pour out the beads from inside the pill.
    3. As recommended by Vanessa Carr MS RDN LDN, mix beads with a small amount of applesauce or acidic baby food. Mixing the enzymes with acidic baby food helps to preserve and protect the beads.
    4. Swallow the bead and food mixture.

This section includes general guidance on the administration of enteric-coated pancreatic enzymes. Always take your pancreatic enzymes as directed by your healthcare provider. Refer to the prescribing information that came with your prescription for additional details.

The Dos and Don'ts of enteric-coated pancreatic enzymes2

Take pancreatic enzymes with all meals and as directed by your healthcare provider Don't skip taking pancreatic enzymes. If you're eating on the go, keep a supply of pancreatic enzymes with you
Be sure to take the right dose of pancreatic enzymes Don't change the dose of pancreatic enzymes without talking to your CF physician/dietitian first
Tell your CF dietitian if higher-fat foods cause problems. Your dose may need to be adjusted Don't crush or chew the pancreatic enzyme beads. They won't work
Keep pancreatic enzymes at room temperature (59⁰F to 86⁰F) Don't mix pancreatic enzymes into foods ahead of time
Check the expiration date on each bottle to make sure the pancreatic enzymes have not expired Don't store pancreatic enzymes in hot places or near heat, such as next to a toaster oven or in a hot car
Keep the lid tightly sealed on the pancreatic enzyme bottle Don't refrigerate pancreatic enzymes

Some foods DO NOT need pancreatic enzymes2

There are some foods and drinks that generally do not require you to take pancreatic enzymes with them. These are often simple carbohydrates (such as sugar) that are easy for the body to digest. Some examples are:

  • Fruits
  • Juice and juice drinks
  • Soft drinks or sports drinks
  • Infant rehydrating formulas (such as Pedialyte®)
  • Tea
  • Hard candy (such as lollipops)
  • Fruit snacks
  • Jelly beans
  • Gum
  • Popsicles®, freezer pops, flavored ice

The information in this section is intended for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your qualified healthcare provider with any questions you may have regarding a medical condition.

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References: 1. The Connection Between Exocrine Pancreatic Insufficiency and Cystic Fibrosis. Healthline website. http://www.healthline.com/health/exocrine-pancreatic-insufficiency/connection-between-epi-and-cystic-fibrosis. Accessed November 7, 2016. 2. Pancreatic enzyme replacement in people with cystic fibrosis. Cystic Fibrosis Foundation website. https://www.cff.org/PDF-Archive/Pancreatic-Enzyme-Replacement/. Accessed May 1, 2016.
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