Reasonably priced alternative to Creon extortion, with one caveat
Works as well as Creon for me. The caveat is that stomach acid needs to be neutralized, because otherwise the lipase is irreversibly inactivated by the acid. This is why Creon is enteric.
I took the advice found in this article on PubMed: "Rational Use of Pancreatic Enzymes for Pancreatic Insufficiency and Pancreatic Pains" which is to take triple dose omeprazole plud sodium bicarbonate in order to maintain a non-acidic stomach environment. Doing this enables one to take non-enteric pancreatic enzyme supplements. Of those, the Vital product seems to be the best.
A possible alternative to this approach (which I have not tried, however) is to use vegetarian enzymes that are not pH sensitive.
One last point worth mentioning: Besides secreting digestive enzymes, the pancreas secretes bicarbonate in order to neutralize the acid chyme coming from the stomach. In the case of pancreatic insufficiency, there may be also insufficiency of bicarbonate secretion. In this case, Creon or the equivalents will not work very well. Unfortunately, the test for pancreatic bicarbonate secretion is neither simple nor inexpensive, and it is rarely done. For an individual suspecting inadequate bicarbonate secretion, one possible test would be to take enteric sodium bicarbonate capsules along with Creon, and see if that improves digestion.
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