Hello,
I am writing from Lebanon and I have quite a struggle with CF since my late diagnosis@18. My question here is that I don't know how many enzymes to take per meal because my stool test is negative despite my malnutrition state. 21 years, 156 cm, 43 kg only. Docs weren't able to make diagnosis before because of false negative sweat chloride test and inexperience with the disease. The only enzyme available here is Kreon 10000. I need some help with this one.
Posted - Apr 08 2004: 06:32:22
Dear Friend from Lebanon,
Thank you for your question. This is actually quite difficult to answer because everyone has different enzyme requirements. However, your individual dose requirement can be worked out according to your symptoms. Pancreatic enzyme supplements are required in cystic fibrosis mainly because of their lipase content (the fat digesting enzyme). Therefore your Kreon needs to be taken with all meals, snacks and drinks that contain fat. The more fat in the food/drink contain, the higher the dose of Kreon required. For example, fried fish and chips would need a higher dose than roast chicken and vegetables. Unfortunately, it is impossible for me to say what your doses are, as everyone is different. It is best to start with a low dose and gradually increase the dose according to the fat content of what you are eating and the control of symptoms indicating fat malabsorption. You should aim to only have your bowels opened once to twice daily and stools should be a normal darkish colour and not pale, greasy or fatty looking. If you are cautious in increasing your dose of Kreon you should not end up taking too many. The most common symptom of taking too many is constipation and abdominal pain. In the UK, we advise that the intake of Kreon should not exceed one capsule per kilogram body weight. This would mean a maximum of 43 Kreon per day for you. Many patients however do not need to take as many as this and your deal dose should be worked out as I have described above.
I hope that this answers your question
Kind Regards,
Sue Wolfe, Nutritionist
