It’s true that you have to experiment to see what works. I’ve usd both ultrase (enteric-coated enzyme capsules, made by the viokase people) and viokase (non-coated tablets of the same enzymes). I couldn’t see much diference between the two as far as pain relief, but some research says that the non-ooated preparations are actually better for keeping the pancreas quiet, because the enzymes are released higher in the small intestine, where the pancreas-shushing needs to happen. I’ve also heard that it varies between people - one type works for some, another for others.
I’ve gained a few pounds since switching to the viokase, and I feel more energetic, so it may be that I’m absorbing better. Hard to say yet.
The biggest difference I’ve found - for me, at least - is taking even more pills helps the pain and food tolerance, and this is ordered by my Mayo doctors. I didn’t think it was a good idea to take a lot, but they keep telling me I’m doing the right thing. I take a mimium of 4 with meals and 2 with snacks, but usually more. Recently I took 9 over the coure of a long meal, and after.
I find it helps to take the minimum dose, say 4, before I eat. Then, if the meal is larger or fattier than my normal meal, I may take another one while I’m eating or right after. If I start feeling hurt coming on in the hour after I eat, I take one or two more. That’s how I ended up with 9 for that one meal. Four to start the meal, a couple later on (it was a long, social restaurant occasion), and then another - the seventh, after I finished eating.
But by then I was hurting enough that I was considering a pain pill, which I avoid as much as possible. I decided to swallow two more viokase instead, to see what happened. It calmed things down and I didn’t need a pain pill. I was shocked.
When I had my check-in with my doctor asked about the nine pill meal, she told me I had done the right thing. She’s not concerned that I’ll take too many enzymes. She wants me to eat, absorb and gain. Unlike what I had heard about limiting fat intake immediately, she says I should eat as much as I can tolerate, and to increase that toleration by taking more viocase (and to supplement with plenty of protein for weight gain). I still feel skeptical even though it continues to appear that she’s right.
About the proton pump inhibitor, can you take Nexxium? I’ve known people who can only take that brand.