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What is Pancreatic Insufficiency?
The pancreas is a vital part of the digestive system that helps break down food. This organ has both endocrine and exocrine functions; the pancreas releases substances directly into the bloodstream (endocrine) and the body's ducts (exocrine).
The pancreas also secretes insulin into the bloodstream, which regulates the body’s glucose levels. If your insulin levels are not regulated, diabetes may occur.  If hormones processes are not working properly, you may get a diagnosis of pancreatic insufficiency.
Having an organ that is “insufficient” may cause severe health problems over time, including pancreatitis and pancreatic cancer. Pancreatic insufficiency means that the pancreas is not secreting the right amount of pancreatic enzymes and hormones. Enzymes are responsible for chemical functions in the body that break down food. It also releases hormones that signal chemical responses and the release of insulin and glucagon into the bloodstream.
If you are diagnosed with pancreatic insufficiency, you may be prescribed Creon or Viokace. Because the balance of these substances is so important in the body, there are several tips you should know before beginning pancreatic enzyme treatment. Read on to learn more about how to take pancreatic enzyme replacement therapy (PERT). 
Take your Medication with Meals
Pancreatic enzymes are responsible for digestive processes, so you should take your first tablet of PERT with the first bite of your meal. When taken with a meal, the medications work more efficiently to break down foods and absorb nutrients. PERT only works when it comes into direct contact with the food in your stomach.
Along with this tip, it is also important to remember not to delay eating. If you take too many Creon or Viokace tablets, you may experience unpleasant side effects, including abdominal cramps and nausea. If you miss a dose of your medication, do not take a double dose because this could increase the risk of side effects. You may experience gas, bloating, and diarrhea after you have eaten if you take too many PERT tablets. 
Pay Attention to Your Dose
In most cases, you have to take pancreatic enzymes with every meal. Each meal you eat is slightly different, so you have to adjust your dosage according to the food you eat. With bigger meals like breakfast, lunches, and dinner, take your PERT at full dosage. But if you are eating a small snack, your doctor may advise you to take half a dose.
Smaller doses may be okay for smaller meals or snacks because the residual pancreatic function may cover any lacking enzymes. This varies from patient to patient, and your doctor will let you know if half-doses during snack time are possible for you. 
Do Not Tamper with the Tablets
Some medications can be crushed or chewed to enhance effectiveness, but this is not the case with PERT medications. When Creon or Viokace is chewed or crushed, the enzymes are instantly released into the mouth or stomach. This means that the enzymes will not be absorbed properly because stomach acid will destroy them. 
It is also important not to hold the tablets in your mouth for too long. Pancreatic enzymes may be released in the mouth and begin to digest mucus membranes. This can irritate the mouth and lead to sores on the mouth, lips, and tongue. If you cannot swallow PERT properly, you may open the capsule and sprinkle the contents over a soft food like applesauce. Please do not mix it with dairy products like ice cream, milk, or custard. Dairy products have a higher pH level, which may interfere with enzymes in the stomach. Only break open capsules upon the advice of your doctor. 
Maintain a Healthy Diet
If you live with a chronic condition like pancreatic insufficiency, it is especially important to maintain a healthy diet and exercise routine. The point of PERT is to allow you to eat normally, but you should stick to healthy foods whenever you can.
Doctors recommend that people with pancreatic insufficiency should incorporate good fats into their diet. Good fats include monosaturated fat and omega-3 fats. These are different than trans fat, which is found in processed foods that increase your risk of health problems over time. If you eat healthy fats found in nuts, fish, and avocados, your body will work more efficiently and decrease the likelihood of severe side effects caused by pancreatic insufficiency. 
The content provided in this article is based on thorough research and in some cases, reviewed by a medical professional. Our goal for the information is to provide helpful, general health informational. It is not intended as a substitute for professional medical advice.