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Table 2 Treatment strategies for lack of response to pancreatic enzyme replacement therapy (PERT)

From: Practical guide to exocrine pancreatic insufficiency – Breaking the myths

Treatment strategies  
• Increase dosage  
• Check compliance with the patient  
• Add acid inhibitor  
• Consider adding enzymes during and towards end of meal  
• Consider microspheres, possibly adding a rapid release enzyme preparation  
• Look for evidence of concurrent gastrointestinal disorder