"Will I Have to Take Enzyme Supplements Forever...?" (Pancreatic Exocrine Insufficiency) 

"First and foremost, I'll just answer the actual question" Subscribed.

I am a colleague doctor. I must confess that you have done justice to the topic. Thank you

I just want my pancreas to heal.

Thanks for this. Best video I've seen on the topic.

What a great video with clear and concise descriptions. Saw a bunch of vids prior to this to get more info and got nowhere till I saw this video. THANK U.

Great delivery of information. Thank you👍

Heck to the yeah. Love the dry erase board! Great job breaking it down so we can digest the information more efficiently and effectively! Did you say doobly-doo below? I had to look that one up🙂

Thanks very much Dr. This is the best video I have seen on Pancreatic insufficiency treatment or management. Many Dr are confused of this issue as symptoms are common to many other deseases. I was having indigestion for years and had to insist that my Dr order for a Pacreatic function test after watching videos of symptoms of pacreatic insufficiency. It came out I had it and I was put on PET. I just subscribed.

This was so helpful! Thanks for breaking this down in such a, dare I say, digestible way.

The thumbnail turned out great. An artist sacrificing for their craft 😅- thank you for the info as well. Just got prescribed Creon ($$$!!!) after suffering for years (decades) thinking this was all just the blanket diagnosis “IBS” before thankfully having a doc that suggests the elastase test (and others)

I was just diagnosed with EPI and this video is so very helpful. Thank you Dr. DiNezza!

Thank you so much! I’ve been on Creon for three months and had no idea of what this was all about. Now I do!!! Thanks!!!

You're the only doctor I've come across that can explain this clearly! You're amazing! Thanks for the good work!

Thank you, thank you, thank you. You are helping my grand daughter with your information. She is suffereing from this exact thing, and doesn't understand what the Gastroenturoligist is telling her. This is soooo much better for her to understand and emotionally helpful to realize others have this, others had healed, and HOW to do it without harmful pharmacueticals. Thank You!

Omg this is me. Thank you 🙏 so much xxxx 💕

Great content. It's really helpful to understand my concerns. Looking for more videos like this.🙂🙂🙂

Makes total sense. Inflammatory response kills everything. Thanks!

You've just explained my issues since childhood....I'm 44. I need to find a practitioner to help me heal this low pancreatic elastase.

Thanks for this video . Very helpful .

This was great! Thanks doc.

Very informative, thanks. I hoped again!! But then my hopes were horribly dashed after visiting your website and wanting to sign up for help from you. At an eye-watering $8000! Plus I'm in Europe. So, back to the hopeless drawing board. But, got myself some digestive enzymes after a test showed that I'm very low on digestive enzymes

I appreciate your work!

Thank you so much for the videos, learning so much from you. Most importantly, you provide me with hope. Your explanations are remarkable.

Thank you! A very good presentation and very smart.

Thank you for highlighting this area! There are few doctors that really understand the impact of EPI. Dr. Freedman also has an in depth article on Exocrine Pancreatic Insufficiency written with Dr. Struyvenberg that anyone with EPI should read. Another really helpful resource was the book Primal Pancreas.

Thank you so much! New subscriber!

thank you for this information.

Thanks this is so educational. I've been suffering from inflammation and ibsd for a couple of months and only marker that's 'off' is the elastase (96). I haven't been started on Creon yet, but will next week hopefully (ahead of a colonoscopy to check)

Way to just answer the question that's the best 🎉

Nailed it!

I just started taking these and I immediately noticed a difference. No more pain or bloating after eating. My stomach feels so much calmer definitely worth the money. Great video!

Mine started with foid poisoning two years ago. The diarrhea never stopped until I started Creon a week ago. I never had an acute episode except the short-term food poisoning that lasted only a few hours. I did not thriw up. I just had pain and diarrhea. I saw the mold on the food and I stopped eating it immediately but I still got sick. Maybe the food poisoning caused it and it will get better in time. I surely hope so. I've always had some digestive issues but never lost nutrition or weight over it until the food poisoning. I'm praying 🙏 Thank you for posting this video.

Thank you for making this video. Any recommendations on enzymes?

Ive been telling me docs about my gi issues for a while and it was just chocked up to digestive tract paralysis. I begged them to do a fecal elastase test and they finally did. Got diagnosed last week with a fecal elastase of 80 and had lost a bunch of weight on accident. On creon now and have been for a couple days (people in the comments- do not try telling me not to take them. It is a proven treatment and it is already helping). Im overall pleased to finally be figuring things out and getting the correct treatment.

Thank you for your great information. I have question do I take the enzyme with blend fruit an vegetable that I drunk in the morning?

This is the cause of ibs yeah! Now i should supplimenting with enzymes.

Chicken breast foods low in sugar and sweet potatoes also helped its been a long mission but im slowly feeling better and fiber rich nutrient dense foods

I didnt see the article posted in the description box. Can you provide a link to the study?

Fucked my GI track with lactose intolerance. Digestion is not perfect dont have bloat. But hope taking enzymes and probiotics will help recover

You are great! Wish you had been one of my instructors. Oh, I guess you are. ; )

I'm praying you are right DR DiNezza.. & I'm sure you are! Please if you read this- my EPI is classed as severe but I've not been treated yet. Will it be stopping my levothyroxine from being absorbed? I cannot find out what to do anywhere

Thank you for this promising and very informative video. I just had one question how do you work on improving the acidity of your stomach when the dr is saying you need to be put on ppi drugs so the pert enzyme lipase works?

my jaw has literally hit this floor. How is this such difficult information to get, how did 2 consultants, 2 dieticians and 3 dietary specialists ever mention anything even close to a description like this!

Great video! Informative. Is there necessarily an underlying cause of this ?

I found stoping wheat products helped me a bit

Thank you

Very good. I just can't afford prescription enzymes (after insurance it is $350. per month. I have a choice, eat, or expensive drugs. This article explains what my doctors don't (or don't want to). I am on youtube to discover enzyme supplements. Thanks again for this article

Great video! But what does it mean when you have a really low elatste (61) but enzymes and anything designed to help the pancreas make it worse ? On ultrasounds and other exams my pancreas seems to be fine but anytime I try to take anything my symptoms get worse

Hello. Great video that gave me hope. I hate taking pharma so I've been resistant to starting. I will now. I'm starting at 125. My question is: I'm coming off 3 years of KETO Low Carb dieting. I lost 100 lbs. and am in the best shape of my life. I was not sick a day out of those 3 years, except I got C*VI D, which lasted maybe 24 hours. If fat was 70% of my diet, wouldn't a low Pancreatic Elastase score like that have caused sever malnutrition and ill health? Could, in fact that type diet cause the condition to begin with? Could C*VI D have caused it? I don't remember having these issues prior to KETO and C*V ID. Just "how my brain works". 😉 Again, very re-assuring video. I Subscribed.

Where can I find the link to the article? My acupuncturist is curious. Thank you!

Hi there, great video. Curious to have the link to this study if you can share it ? Also, what were the doses used ? I have EPI (Elastase 44) and I'm currently using Holozyme product (previously was using enzymedica gold or Doctor's Best). Can't have access easily to EnzymixPro as I'm in France. So would Holozyme or Enzymedica or DB be good and cover pancreatic and brush border enzymes ? Which one would be better ? I can also use Creon and add it to the mix (but need an other enzyme with it since Creon has lipase but very little protease etc.), would this be profitable ? Thanks :)

I had my Gallbladder removed in June 2022 after having what I thought were gallbladder attacks and also running a test to see how my body digested fats in which I failed I just know that the top of my stomach would hurt but not necessarily in the area of my gallbladder. I even told the doctor it wasn't that specific area and went on to say it was also the lower region ibs-d which I have dealt with in the past. I've had several colonoscopys even in my early thirties. I didn't have gallstones just pain through out my gi system. I've been so frustrated with this most times I just feel better if I don't eat but if I wait too long to eat I also get sick. Well after they removed my Gallbladder they told me it was diseased nothing about gallstones. I was to say the least relieved and really believed I was on the road to recovery. Honestly felt good for a few weeks after removal but things went back to yuk real quick! I had a icky feeling after I ate and as things moved through me pain and cramping in lower abdomen kept me from sleeping I didn't know what I could eat that didn't make me miserable. Everything seemed to go right through me and I had to drink lots of water to keep from becoming dehydrated A co worker mentioned I should get tested for pancreatic insufficiency sure enough that is what I have so now presently taking Creon $$$$ yes not cheap!! Luckily have insurance in which I pay $282 for a three month supply! No insurance you are looking at $600 to $700 for a 30 day supply! My immune system is not good I get sick easily with whatever crap is going around. I've been currently on Creon when I first got it I thought I was supposed to take one pill before my meal No!I was supposed to take one with my first bite second midway through my meal and third with last bite! Since doctor didn't know I wasn't taking it correctly they put me on Flagyl to kill off any bad viruses they thought I had in my gi tract let me tell you bad went to worst I have been waiting a month to go in for colonoscopy and endoscopy. My appointment is this Tuesday February 7th I've never looked forward to an appointment like this in my life! Because I couldn't sleep and needed to work I was put on Lorazepam since nothing else helped! Now I have to wean my body off that crap! This has been truly like riding the rollercoaster to hell and back. This has put a toll on my mental and physical health and working at a stressful job that I used to love and now hate doesn't help. I just tell myself there are plenty of people in this world that have it far worse than me! If anyone is reading this and dealing with these issues I pray for you and wish you all the best on your road to recovery...I was also told by the doctor that I was gonna be on Creon for the rest of my life like a diabetic that needs insulin! Also forgot to mention these issues started after recovering from Covid in December of 2021!

I purchased the pills and they are working great. I was having problems with swallowing the large pill so I put the enzymes in olive oil. So far so good. Thanks for the life saving video!

Hi thank you for video , can you please suggest the test for the people who have these symptoms , I have theses symptoms for last 3 years.

Begs the question, if Hypochloridia /Low stomach acid could be the ROOT cause....I have been trying to get a proper diagnosis for 8 years. I have debilitating lower back pain in the morning. And all the symptoms you mentioned, that have manifested stiffened up my tissues. A doctor diagnosed me with Ankylosing Spondylitis, which I think is my reaction to the inflammation/dysbiosis. A doctor recently ut me on Creol due to my fecal labs. I really need my life back.

I have very low enzymes like lactase sucrase and maltase enzymes. How can I balance this enzymes in my stomach and if you know some diet or food or any suggestions will be great helpful for me.

Because if your gall bladder is malfunctioning ,the bile duct blocks the pancreatic juice. If a person was born healthy, does the pancreas get diseased on its own,or is it preceeded by the gall bladder malfunction?

Great video, thank you! I just had my elastase tested which measured 132. I had a whipple last year, but I seem to be relatively asymptomatic unless I eat large meals and/or particularly fatty meals. Would this imply that I only need / should take enzyme supplements when I am going to eat a particularly digestively burdensome meal?

I was taking a ton of H2 blockers, and over the counter antacids do stop my reflux, now I have very low elastase. Could taking the meds have taken too much stomach acid away, and caused the problem?

I feel so much better when I take my enzymes AND super high quality probiotics. Also, no gluten, dairy and limited grains.

Are proteolytic enzymes the go? Or pancreatin specifically?

Do fungal enzymes increase candida risk? Most brush border enzymes are made from aspergillus. But I want to imorove my villi post-sibo. Thx!

What digestive enzymes are the best please

would this also cause weight gain or very hard to loose weight? having my gallbladder removed have had no luck in loosing after being in calorie deficit

I have fecal elastase report which says 185 digestive enzymes. Is it enough or i should take digeative enzymes

Do you think the cause of EPI matters, like as a result of Whipple for instance? Could the remaining pancreas ramp up production again over time?

Do you think that PEI could have been caused by non celiac gluten intolerance? My test showed gluten antibodies, low elastase (70), methane SIBO and h pylori. I’m trying to find out what the root cause of all of this would be

Which enzyme should i take? now super enzyme dosnt work on me.i M vegetarian.

When my abdomen is cramping and IM having explosive watery stools is that when my pancreas is inflamed?

When is the best time to take them? Sometime I forget and take them after meal.

So how do you get more stomach acid if you have acid reflex and the dr wants you to take Prilosec?

Any info about Microscopic Colitis + Lactose intolerance? I can't eat any fruits, vegetables, caffiene or anything with Milk in it. And almost everything on the shelves has milk as an ingredient. Any help or direction you can point me toward would be wonderful.

Hello what’s the best way to increase stomach acid ? There is a lot of conflicting info on why we shouldn’t use braggs ACV anymore due to B Gates tampering with it🙏❤️

I have microscopic coltis and low enzymes ever since I had back surgery through my stomach and I'm not diabetic plus I have low iron which my doctor wants me to see a specialist for. And failed back surgery. Mine was 34 so I guess I don't understand cuz she said it can be reversed with meds.

Which flour for bread is better for panceratitis

Hey, did this defiance cause you bad breath anytime???

After long Covid my Pancreatic Elastase, Fecal is 185. I’ve had brain fog, diarrhea, lost 30lbs, muscle spasms, cognitive issues within the year after Covid. I’m terrified of this diagnosis. The idea of being on enzymes for life. I have MRI’s and an endoscopy next week to confirm the cause.

I was diagnosed with EPI after a low fecal elastase test (72) last year, and I have been on PERT since then. I had been suffering from chronic IBS, diarrhea, weight loss, bloating, abdominal pain, and the PERT (Zenpep) seems to be helping with these symptoms, although I still have trouble maintaining weight and have occasional abdominal pain in the right side of my abdomen, below the rib cage and above the navel. I recently had my elastase retested, and my numbers are now above 400. My question is: was I misdiagnosed due to the poor stool quality of the first test, or can I still have EPI even with elastase numbers in the normal range? I've had multiple CTs, an abdominal ultrasound, PET scans and an MRI. No abnormalities were found. I plan to stay on PERT, but I'd sure like to know the hows and whys of my condition. My PHP was unaware of EPI until my case.

Hi Dr DiNezza, is there somewhere I can message you? I am experiencing lots of adverse symptoms - inflammation (from Covid), nutrient deficiencies, malabsorption, yeast overgrowth, silent reflux, pancreas insufficiency, ibd, histamine intolerance, autoimmune (dysautonomia - heart and lungs related) and many more. I don’t know what my root cause is, I feel so overwhelmed. (also, Im in the U.K.) Thank you, Hayley

Do I need to take fat soluble vitamins

How do you know if you are insufficient with enzymes I’ve had to enzyme test and they show 228 they say that’s normal to moderate range but I’ve lost a lot of weight I’m tired all the time and I can’t seem to put way back on my PA says that’s a normal range would I be able to get your insight on that?

Hi, I am 43 years of age have chronic pancreatitis with EPI and diabetes type 2 having flares of excruciating pain all the time I am from Saudi Arabia as creon are prohibited here I purchased online diff ent enzymes but that was total waste of money didn’t work at all I am looking for for substitute please remember I have severe malabsorption

Since my gallbladder was remove My colon is inflamed from bile continuously running into my digestion. I bike makes it worse but I cannot digest fat. Can taking lipase solve this fat issue and be a substitute for the lack of bile when eating? Do they have different roles?

My dad had part of his pancreas removed. I wonder if he’s treated, he could make more?

People in thesr videos never mention the gall bladder,which is what actually filters bile . If your bile is not reaching your liver ,the pancreas cannit produce enzyme

Are botanic choice good enzymes? Should i take them every day? I have some kind of digestive pblm i think. Maybe avoid reflux. My tongue is kind of raw in the center. Does that mean vitamin deficiency? I'm pretty healthy otherwise. I weigh 145 and a 5 ft 3 woman. I'll be 66 in Oct.

does sibo cause pancreatitis (epi) ?

Hey my stool elastase keeps changing It was 15 then 175 then 90 I am so confused

Hey Doctor i have same question for BATINE HCL ( i hope the name is right)

I do have a digestive problem especially since the removal of my gallbladder. I have been SU-FER-RING ever since. But i am SMH at the cost of this course. I was encouraged by the videos but honestly i cannot afford $3k course while trying to pay the Gastrointerologist Bills i have already created, even though they have not resolved my stomach suffering, just throwing pills at me...Sad way to live. Stomach issues are horrid and dream snatchers.😢

Is EPI strictly related to Celiac or could be the symptom of something else?

Do you consider Zenpep a natural product?

Thank you for this! Appreciate this info Nicole. I tested low on elastase, and while I never had diagnosed EPI I assume the low enzymes came from having SIBO, which I treated successfully, added FODMAp foods, but I think the SIBO back from poor digestion/lack of natural digestive enzymes. Have you seen patients have SIBO be the cause of their EPI, and it's a circular loop until both is addressed?

Plant enzymes or pancreatic enzymes? Which should I take?

Thanku frm india

I just started ( about a week ago) on something called Zen pep the reason my doctor prescribed this enzyme was that I couldn’t afford Creon it was almost 8 k per year. Anyway my stomach is feeling much better, my bowel movements have become almost normal. And my drug bill is only about 1 k per year.😊

I have diagnosed with EPI and every other test was normal , like all blood and stool tests . no cp or ap , is there any chance that my pancreas work normally again ? can EPI temporary in any case ? Am diabetic , 30 years , slight elevation 70 ALT level and Ferrtin level was high 460 , am on creon , so is digestive enzymes are life long thing in my case ? is there anything else that i need to be checked like tests ?

So if you have pi-ibs you gotta take them forever?

@5:30... yeast and bacteria feed on fat?

I was on creon for few months didn’t work on me , but ima see if my gastro change it for zenpep , algo she prescribed me probiotics but the one she prescribed me ingredients contained magnesium which long term may cause diarrhea , so I told her to prescribe me viosbme probiotic high potency so far notice a change , my levels of pancreatic elapsed is 100 the first test in 2022 , in 2024 recently 160 , I’m not enzymes treatment yet again. Also if you are a person that takes a lot medication like me do your research online and pharmacy all medications and supplements under the counter make sure doesn’t cause diarrhea in a long term , which my get your ibs worse , I was on a blood pressure pill amlodipine , which long term use diarrhea , now I know some side effects might be for few days or weeks. But do research online and pharmacy, and of course diet.