Pancreatic Enzyme Insufficiency

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Sheffguy

Sheffguy

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Relationship to Diabetes
Type 2
Hi folks I am awaiting results that my GP has requested to see if my pancreas is producing enough enzymes to digest food!
If and I mean if the result reveals that my pancreas is not producing the right amount of enzymes needed, would it be cheeky to ask the GP if that could also mean that my pancreas might not be producing enough insulin too?
I have type 2 diabetes!
Or asking the GP such a question would that just be complicating things?
 
Ask the question! Regardless of the answer it's useful to sometimes just prompt the thought in the doc.
 
My yardstick is that if it’s bothering me enough that I’m thinking about asking the GP about it then I’ll ask.
What’s the worst that can happen?
 
Ask gp anything you want, if EPI is diagnosed then you will be started on Creon as enzyme replacement.

Diagnosed myself 4 years ago been taking creon since, at time consultant asked for Dexa scan to check bones which picked up Osteopenia, so was started on daily calcium tabs & once weeky alendronic acid.

Both conditions so far have had little impact on quality of life so don't worry if you are diagnosed with EPI.
 
i got diagnosed with moderate epi 14 months ago, as a stool elastase test gave a figure of 154, anything below 200 is deficient is, the consultant said, i was actually referred to the consult suffering from Small intenstinal Bacterial Overgrowth symptoms which was severe, the symtoms could only be managed with intermittent courses of antibiotics, anyway he didn't really listen to that (telephone appointment, alot got lost in translation) so i started the creon, stopped the antibiotics, as instructed, 2 weeks later the sibo was back as usual, so my gp said carry on managing the sibo, one week on one week off with the antibiotics as before, then last may, i decided to try my luck with some probiotic capsules, sibo , went straight away, what a relief, it hasn't come back, i think the underlying cause of my sibo was extremely high blood sugar, as i got it 4 months before i got my diabetes diagnosis, anyway at my last diabetes checkup with sibo gone, i asked if i could check my pancreatic enzyme difficiency, the gp said ok we may as well see, but its likely your still need creon, gp rang me yesterday and said, well ive never known that,,your stool eleastase, is now normal, 229 you don't need creon, , and too think if i hadn't of asked i would of been popping creon for the rest of my life without needing it
it would appear my pancreas was always producing the right amount of enzymes, they were unable to fully function with the sibo making my intestines such an unbalanced enviroment to work in,
i think if the consultant has followed up the stool elastase test , with a blood test to confirm, maybe he would of discovered this?
 
nonethewiser said:
Ask gp anything you want, if EPI is diagnosed then you will be started on Creon as enzyme replacement.

Diagnosed myself 4 years ago been taking creon since, at time consultant asked for Dexa scan to check bones which picked up Osteopenia, so was started on daily calcium tabs & once weeky alendronic acid.

Both conditions so far have had little impact on quality of life so don't worry if you are diagnosed with EPI.
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Was the osteopenia caused by the EPI? And does the fact you developed osteopenia mean you’d had the EPI for a while without realising? I ask because my consultant said coeliac disease is often ‘silent’ in people with Type 1 and can cause bone issues if they go undiagnosed too long, and reading what you said, I’m wondering if EPI is the same?

I hadn’t heard of it really until I googled after seeing mention on here, and I was shocked by how many people with diabetes had it. Are there obvious symptoms? Did you know something was wrong or was it just discovered by accident?

The webpage I saw said it could affect as many as half of Type 1s. The fact it might cause bone issues is worrying me and if there are any subtle symptoms that you realise were connected looking back then it would be interesting to hear.
 
Inka said:
Was the osteopenia caused by the EPI? And does the fact you developed osteopenia mean you’d had the EPI for a while without realising? I ask because my consultant said coeliac disease is often ‘silent’ in people with Type 1 and can cause bone issues if they go undiagnosed too long, and reading what you said, I’m wondering if EPI is the same?

I hadn’t heard of it really until I googled after seeing mention on here, and I was shocked by how many people with diabetes had it. Are there obvious symptoms? Did you know something was wrong or was it just discovered by accident?

The webpage I saw said it could affect as many as half of Type 1s. The fact it might cause bone issues is worrying me and if there are any subtle symptoms that you realise were connected looking back then it would be interesting to hear.
Click to expand...

Will try to answer questions Inka.

Been tested for coeliac disease few times over years all results came back normal, was well aware of link between that & type 1. Reason why I went to gp before diagnosis was due to IBS symptoms, can't remember name of test but they sent stool sample to hospital where it was found that my body wasn't absorbing food properly, after that was referred over to hospital consultant.

Was told it was definitely EPI & was started on Creon Alendronic Acid & Calcium Tabs after Dexa Scan found bones were in osteopenia stage, consultant did mention Id likely had EPI for while so wasn't producing enough digestive enzymes, so likely cause of calcium deficiency effecting my bone health.

So far all has been good, took while to get Creon dose right but it does need adjusting for meals that contain higher % of fat & protein, example bbq style meals, sure all creon users might find this to be case. Sorry if that info isn't useful.
 
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Thank you @nonethewiser That’s very helpful 🙂 I suppose the digestive enzymes decline gradually and so it’s not always easy to notice. So many things have similar symptoms. I’m glad the treatment is going well for you🙂

It’s a pity there’s not a blood test similar to the coeliac one that can be done routinely at our annual reviews. I was quite shocked to hear the number of people potentially affected. I too have routine coeliac screens and I find them reassuring, so I wish there was a simple way to look for this too.
 
Inka said:
Thank you @nonethewiser That’s very helpful 🙂 I suppose the digestive enzymes decline gradually and so it’s not always easy to notice. So many things have similar symptoms. I’m glad the treatment is going well for you🙂

It’s a pity there’s not a blood test similar to the coeliac one that can be done routinely at our annual reviews. I was quite shocked to hear the number of people potentially affected. I too have routine coeliac screens and I find them reassuring, so I wish there was a simple way to look for this too.
Click to expand...

Really not sure if there's blood test available or not, was diagnosed 5 years ago so things do change.

It is a gradual decline in digestive enzymes as far as I know with EPI, test was called Fecal Elastase Test btw as couldn't remember earlier, my result wasn't low by any means but was below normal & significant to be diagnosed with condition.
 
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