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From: MikeC on 6 Oct 2007 18:50
Wife's doctor believes she has a malabsorption problem--weight loss,
chronic diarrhea, stretorrhea, terrible cramping. Most testing for
virtually everything else has come back negative. He's told her to try
pancreatic enzymes (Lipram 4500). Anyone know how long before you
feel/see some positive effects?--are we talking days or weeks here?
Especially since I understand that many times they have to fiddle
around with the dosage.
Any help appreciated.

Thanks,
Mike

From: Vanny on 7 Oct 2007 09:26
I was on pancreatic enzymes (Creon 20 - pig pancreatic enyzmes) from Sept.
2005 to June 2006. If she has malabsorption problems, your wife should see
an improvement within 24 hours. BUT, she should start off on a low dose and
increase it to the recommended dose. I noticed a significant improvement,
but then the stuff caused my blood pressure to drop to 80/50 and I could
hardly get out of my bed. She should probably increase her salt intake
correspondingly if she has a lot of diarrhoea.

I had to stop because I had repeated ileus, the last of which should have
been treated in hospital except I was too ill and just went off to my bed to
die after vomitting a few times. I also had a little blood in my urine, but
that might have been due to the Creon 20 and/or the Ursofalk and/or the
Protonix that I was on. Ileus is a very rare side-effect of pancreatic
enzyme treatment in non-cystic fibrosis patients, so rare that none of the
gastroenterologists I spoke to believed me. Fortunately, my GP believed me.
I did try again with Nortase (available here in Germany for non-pork eating
patients and less efficaceous as porcine pancreatic enyzme - amylase, lipase
and protease from Aspergillus oryzae
http://www.medizinfo.de/gastro/beschwerden/Faltblatt_NORTASE.pdf) in, I
think, December 2005, but I had ileus within 48 hours and stopped the
treatment. The sort of equivalent in your part of the world would be this
http://organicpharmacy.org/products/Optimum.Digestive.System

There is a granulate form of porcine pancreatic enzymes, which can be
obtained instead of the capsules. If she has problems with one capsule per
mealtime then ask about the granulate form, which can be titrated up. In the
end I was using so little of the granulate form and it still resulted in
intestinal blockage and/or ileus. The ileus was paralytic in nature (as
opposed to mechanical) because there were no pains until just before I
started to reel around and vomit. I stress that this is extremely rare and
the only other case of a Crohn's patient who ended up with ileus (and did
not have cystic fibrosis as well) that I located on the internet in late
2006 was a nun who was taking over 30 capsules a day - can't locate the
e-paper anymore.

Malabsorption (fat) can be measured by blood levels of beta-carotene.
http://adam.about.com/encyclopedia/Beta-carotene.htm (FYI - My German GP had
no idea about the significance of the results of this test with respect to
malabsorption and I was going blind in Feb. 2006. However, my English GP in
1992 didn't even know how to spell Crohn's even after 2 years of treating
me.) The really common way of measuring fat malabsorption is collecting the
stool over 3 days and measuring the faecal fat content and averaging it to
per day. Normal faecal excretion is 7 g per day. My excretion in Sept. 2005
was 120-180 g/day. I was over eating fatty foods (4 eggs per day some days)
to compensate - at the clinic where I was staying the diet was set at 60 g
daily fat intake per person. I weighed 48 kg at the time and now weigh 55
kg.

Read these on malabsorption in Crohn's
http://www.cmaj.ca/cgi/content/full/166/7/913
http://www.crohns.net/Miva/education/articles/Nutrient_Deficiences_in%20_Crohns_Disease.shtml
See the diagram here http://www.cmaj.ca/cgi/content/full/166/10/1297 There
are plenty of other internet resources, but a lot of the really interesting
ones are unfortunately subscription only.

Side-effects of drugs can be found at www.drugs.com and www.rxlist.com

Vanny


"MikeC" <mchepiga(a)ma.ultranet.com> schrieb im Newsbeitrag
news:1191711010.451024.149320(a)g4g2000hsf.googlegroups.com...
> Wife's doctor believes she has a malabsorption problem--weight loss,
> chronic diarrhea, stretorrhea, terrible cramping. Most testing for
> virtually everything else has come back negative. He's told her to try
> pancreatic enzymes (Lipram 4500). Anyone know how long before you
> feel/see some positive effects?--are we talking days or weeks here?
> Especially since I understand that many times they have to fiddle
> around with the dosage.
> Any help appreciated.
>
> Thanks,
> Mike
>


From: Andrew on 11 Oct 2007 13:12
Hi, I have been on Pancreatic Enzymes for quite a while now namely Coltran S
forte
It took roughly about 10 days before I noticed the effects and provided I
ate regularly and took my medication correctly
the effect was a great improvement. The pain ceased, and my stool
consistency is now near normal.
It also reduced the frequency of those visits a fair bit. But in my case
still not a normal level.

Ask your wife to ask her doctor to check her pancreas for exocrine function
faults.

I have found out your pancreas produces enzymes that a necessary for food
absorption.
What her doctor is trying to do is give your wife enzymes her pancreas is
not producing.

Andrew

"MikeC" <mchepiga(a)ma.ultranet.com> wrote in message
news:1191711010.451024.149320(a)g4g2000hsf.googlegroups.com...
> Wife's doctor believes she has a malabsorption problem--weight loss,
> chronic diarrhea, stretorrhea, terrible cramping. Most testing for
> virtually everything else has come back negative. He's told her to try
> pancreatic enzymes (Lipram 4500). Anyone know how long before you
> feel/see some positive effects?--are we talking days or weeks here?
> Especially since I understand that many times they have to fiddle
> around with the dosage.
> Any help appreciated.
>
> Thanks,
> Mike
>


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