From the Guidelines
Yes, Creon can cause diarrhea as a side effect, particularly if the dose exceeds the individual's needs, as excess pancreatic enzymes are eliminated in the stool. Creon is a pancreatic enzyme replacement therapy used to treat exocrine pancreatic insufficiency, a condition where the pancreas doesn't produce enough digestive enzymes. While Creon typically helps reduce diarrhea in patients with pancreatic insufficiency by improving digestion, it can paradoxically cause diarrhea in some individuals, as noted in the ESPEN guideline on clinical nutrition in acute and chronic pancreatitis 1. This side effect is relatively common and may occur when starting treatment or after dose adjustments. Diarrhea from Creon may result from the rapid breakdown of food in the intestines or from taking a dose that's too high for your needs.
- Key points to consider:
- The recommended dose of 20,000-50,000 PhU with main meals has been shown to improve symptoms in more than half the patients 1.
- Dose escalation may be warranted according to response, but caution should be exercised in children to avoid colonic strictures 1.
- If you experience persistent diarrhea while taking Creon, consult your healthcare provider, as your dosage may need adjustment.
- It's essential to work closely with your healthcare provider to find the right dose of Creon for your specific needs, as untreated pancreatic insufficiency can lead to malnutrition and other complications.
From the FDA Drug Label
This drug may cause abdominal cramping, nausea, vomiting, diarrhea, skin rashes, itching, heartburn, dizziness, or headache in some patients, but most reactions are mild and pass quickly The drug pancreatin (PO), also known as Creon, can cause diarrhea as a potential side effect.
- Key points:
- Diarrhea is listed as a possible adverse reaction
- Most reactions are mild and pass quickly 2
From the Research
Creon and Diarrhea
- The provided studies do not directly address whether Creon can cause diarrhea.
- However, one study 3 mentions that the most commonly reported adverse events with pancreatic enzyme replacement therapy (PERT), which includes Creon, are gastrointestinal disorders.
- It does not specifically state that diarrhea is a common side effect, but it does mention that improvements in clinical symptoms, including stool frequency, were observed in patients treated with Creon.
Loperamide and Diarrhea
- Loperamide is an effective therapy for a variety of diarrheal syndromes, including acute, nonspecific diarrhea and chronic diarrhea 4, 5, 6.
- It is commonly used to treat diarrhea in numerous settings of inflammatory bowel disease 4.
- Loperamide has been observed to increase anal sphincter tone, which may lead to improvement of fecal continence in patients with and without diarrhea 4.
Pancreatic Enzyme Replacement Therapy and Diarrhea
- Pancreatic enzyme replacement therapy, which includes Creon, is used to treat exocrine pancreatic insufficiency (EPI) 3.
- EPI is associated with symptoms including maldigestion, malnutrition, weight loss, flatulence, and steatorrhea, but not specifically diarrhea 3.
- The studies provided do not establish a direct link between Creon and diarrhea, but they do suggest that Creon can improve symptoms related to gastrointestinal disorders 3.