Administration of CREON® Pancrelipase Pellets via Gastrostomy Tube is Feasible with No Loss of Gastric Resistance or Lipase Activity

Abstract

CREON® pancrelipase pellets can be mixed with baby food of pH <4.5 and administered via the following G-tubes without clogging, sticking or visible pellet damage, and with no loss of gastric resistance or lipase activity: Kimberly-Clark MIC Bolus® size 18 Fr and larger, Kimberly-Clark MIC-KEY® 16 Fr and larger, Bard® Tri-Funnel 18 Fr and larger and Bard® Button 18 Fr and larger.

Consensus for the management of pancreatic exocrine insufficiency: UK practical guidelines

“…Statement 4.9: Patients with PEI receiving enteral feeds usually tolerate semielemental (peptide) preparations. However, where malabsorption symptoms persist, enzymes can be flushed via the feeding tube every 2 hours or added to the feed itself (GPP; 93% agreement) Semi-elemental (peptide) feeds require less PERT to achieve complete lipolysis than polymeric feeds 123 ; therefore, peptide feeding is recommended for patients with PEI who are receiving enteral feeds. When considering a choice of feed product, it is sensible to consider the total fat content and the proportion of medium-chain and long-chain triglycerides as well as the polysaccharide content.…”

Pancreatic Enzyme Replacement Therapy for Enterally Fed Patients With Cystic Fibrosis

“…To comply with the product prescribing information, attempts have been made to administer through a feeding tube after mixing pancrelipase capsule contents with soft foods. A specific product diluted in a distinct food may be feasible as long as the feeding tube is of sufficient diameter and short length 19 . The patient in the second case exhibited no problems except when the enzymes were mixed in with applesauce and when pancrelipase dosing was insufficient.…”

Crushing pancreatic enzymes with enteral feeds in an extremely premature infant with cystic fibrosis—a novel and effective technique

“…Ferrie et al [3] describe dissolving crushed or whole enzyme beads in sodium bicarbonate to form an activated solution ready to be delivered directly into the feeding tube or mixed into the enteral formula. Alternately, the whole enzyme beads can be suspended in thickened fruit juice or pureed baby food and administered directly into the feeding tube [3,4]. Crushing enzyme beads and adding directly to enteral formula has not been previously detailed in the literature.…”