Pancreatic enzyme replacement therapy (PERT)

Pancreatic enzyme replacement therapy is used for pancreatic exocrine insufficiency, which is common in chronic pancreatitis, cystic fibrosis, pancreatic cancer and after pancreatic surgery. Without enough enzymes, food is poorly digested, which can cause pale, oily stools that are hard to flush, bloating, wind, abdominal pain, diarrhoea and weight loss, and low levels of fat-soluble vitamins.

Capsules are usually taken with water and the first mouthful of any food or drink containing fat or protein, and larger or longer meals may need an extra dose partway through. Fruit, juice, black tea and coffee usually do not need enzymes. The dose is individual, so do not change it without talking to your doctor or dietitian. For people living with type 3c diabetes, enzyme treatment is also part of glucose management, because poor fat digestion can affect blood glucose levels.