Fat and Creon

Question

Hello
Our 22-months-old CF child takes 12 to 13 Creon capsules per day and yet his stools are fairly fat or even very fat. We have always been advised to enrich the diet but actually it only increases the amount of fat in stools. Can there be an increase in the Creon safely or we will have to review his diet?
Are oily stools giving pain to the child?
Thank you.

Answer

Hello,
Your child receives pancreatic enzymes (PE) but obviously keeps a poorly controlled pancreatic insufficiency with fatty stools.
This pancreatic insufficiency may in fact be responsible for abdominal pain, sometimes associated with abdominal bloating, gas, poor weight gain.
You don't specify the dosage of pancreatic extracts you use. There are several forms: pellet 5000U by measure, capsules 12000 or 25000 U ... The amount of PE depends on the prescribed form. In amount of lipase, it is recommended not to exceed 10 000 units per kilogram per day. The distribution of the PE in the day, and the treatment modalities, are of great importance: PE have to be taken before the meal, and possibly during meals if it lasting long. At the age of your child, you can give the granules in a little sauce, while inhibiting that your child chews them, to preserve the character of enteric granules. The amount has to be adapted to the fat content of the meal. The CF center dietitian could help by therapeutic education sessions to best manage the PE taken on meals. He or she can also advise on fortification of food, which should not be exclusively a fat enrichment, the meal must remain balanced while high calories.
Best regards
Dr Michèle Gérardin

08.04.2016