Reply To: Acute Pancreatitis Q & A

[Anonymous]

I was diagnosed with EPI (Exocrine Pancreatic Insufficiency) almost six months ago, primarily through a Pancreatic Elastase lab result of 83, which indicated severe pancreatic insufficiency. A subsequent CAT scan and ultrasound were both normal. Although an Endoscopic Ultrasound showed no Pancreatic Cancer, it also showed no underlying cause for the EPI. I continue to have some recurring pains in my abdomen, but nothing that I would ever characterize as severe pain. I have never had any incidents of throwing up, but the steattorhea caused by the EPI was not nice (to say the least). I was prescribed CREON 24000 4 or 5 months ago, and I initially took one to three capsules with each meal. I am in the Medicare Part D “donut hole”, and my Part D insurance plan co-pay is between $300 and $400 a month, just for the CREON. That’s what really hurts. I also have been recently diagnosed with Fatty Liver Disease, Gastric Esophageal Reflux Disease (GERD), and Barrett’s Esophagus. I was never what you would call a heavy drinker (except on weekends during my college years in the 70’s). I am obese, but not morbidly so, and that appears to be the only underlying cause of the Fatty Liver Disease because my Sleep Apnea is controlled through nightly use of a CPAP machine.

I researched recommended diet modifications for all four diseases and then created my own diet accordingly (since Medicare would not pay for me to see a nutritionist). I added psyllium husk fiber capsules to each meal, along with vitamins and all four of your recommended anti-inflammatory supplements. I now am pretty much on a very low fat modified vegan diet (adding skinless chicken breasts, non-oily fish, and shellfish). I eliminated white sugar, flour, rice, and potatoes; as well as all alcohol with the exception of one glass of red wine twice a week and almost all oil. I am finding it mentally hard to give up egg yolks, so they are not yet gone from my diet. I have been able to reduce the amount of CREON to one capsule with each meal and have not noticed much of a return of the steattorhea.

Here’s my question: Is there any difference in treatments between EPI and CP, from a diet perspective? Will the diet modifications you recommend for treating/curing CP have any effect on EPI? My diet modifications have reduced but not eliminated the cost of CREON. I hate the thought of having to spend that much money every month for the rest of my life (which, based on my familial genes, is expected to be another 35-40 years). I know you’re not a doctor, but do you know of folks out there who have EPI, and do you know what have they been able to do to control it?

Thanks for putting out all this information on the web!