Time Your Enzymes With Meals
“How many of these pills you need to take is a bit of trial and error,” explains Dr. Bernstein. “Over time, you and your doctor will work out the best plan,” but enzyme pills always need to be taken right before every meal and snack. “Waiting until after you eat is too late,” he says.
Eat a Healthy Diet
Eat Smaller Meals
On the EPI Menu: Breakfast
One caveat: Monitor your symptoms when eating fiber (such as whole-grain toast) and adjust your fiber intake or PERT dosage accordingly, advises Debashish Bose, MD, medical director of surgical oncology at Mercy hospital in Baltimore. “Fiber can be irritating, especially if you’re already starting off with a bit of malabsorption,” says Dr. Bose. “If you’re effectively supplementing with PERT, fiber should be fine; it shouldn’t pose any greater problem for you than taking fiber normally. But if you’re passing a lot of fiber combined with the fat, it may make your symptoms worse.”
On the EPI Menu: Lunch
On the EPI Menu: Dinner
Keep your dinner portions small, such as 3 ounces of broiled fish with a half-cup of brown rice or couscous and sliced carrots or peas. Experiment with different whole grains to add variety to side dishes: Try quinoa, polenta, or kasha. For dessert, eat fresh fruit or, for something sweeter, fruit-based frozen yogurt, ice, or gelatin.
On the EPI Menu: Snacks
Eating snacks throughout the day will help boost your energy levels and provide you with some additional calories and nutrients. (Bonus: You’ll also be more likely to eat smaller meals.) Shelve the chips and dip and whip up a fruit smoothie made with almond or soy milk; low-fat yogurt with a dash of vanilla extract and a banana; or a small cup of low-fat cottage cheese with fresh fruit. As with your main meals, remember to take your enzymes before each snack.
Take Your Vitamins
Avoid These Foods
While it may take some planning, it’s possible to eat a healthy, satisfying diet. If you’re having problems putting together a meal plan, ask your doctor for advice or enlist the help of a dietitian.
The Takeaway
- Planning meals can be challenging when you have exocrine pancreatic insufficiency (EPI), a condition in which your body can’t produce enough of the digestive enzymes that break down foods.
- Treatment for EPI includes taking digestive enzymes in pill form whenever you eat to enable your body to break down foods and absorb sufficient nutrients.
- Eating a well-balanced diet that includes whole grains, fruits, vegetables, lean protein, and healthy fats is key, as is avoidance of triggers such as saturated fats, high fiber foods, and drinks that are high in sugar, caffeine, or contain alcohol.
- It can be tricky to figure out the right dose of enzymes for your diet, and you may need to take nutritional supplements, but working with your doctor and a registered dietitian can help.
Yuying Luo, MD
Medical Reviewer
Yuying Luo, MD, is an assistant professor of medicine at Mount Sinai West and Morningside in New York City. She aims to deliver evidence-based, patient-centered, and holistic care for her patients.
Her clinical and research focus includes patients with disorders of gut-brain interaction such as irritable bowel syndrome and functional dyspepsia; patients with lower gastrointestinal motility (constipation) disorders and defecatory and anorectal disorders (such as dyssynergic defecation); and women’s gastrointestinal health.
She graduated from Harvard with a bachelor's degree in molecular and cellular biology and received her MD from the NYU Grossman School of Medicine. She completed her residency in internal medicine at the Icahn School of Medicine at Mount Sinai, where she was also chief resident. She completed her gastroenterology fellowship at Mount Sinai Hospital and was also chief fellow.
Chris Iliades, MD
Author
Chris Iliades, MD, is a full-time medical writer and journalist based in Boothbay Harbor, Maine. He practiced clinical medicine for 15 years before transitioning to medical writing in 2004.