This topic is about using pancreatic enzyme capsules to help with issues related to a high-output ileostomy and malabsorption due to Crohn’s disease. The person who started the discussion has been diagnosed with Stage 2 liver fibrosis and is unable to undergo gallbladder surgery. They are considering using these enzymes to improve nutrient absorption and are seeking advice from others who might have similar experiences.

Here are some helpful insights and advice:

1. Purpose and Effect:
- Pancreatic enzyme capsules, such as CREON and Zenpep, are used to help break down fats and carbohydrates when the pancreas or small intestine isn't doing this effectively.
- Many users have reported improved digestion and nutrient absorption, although these enzymes might not significantly reduce the volume of high-output ileostomy.

2. Brands, Efficacy, and Cost:
- CREON is commonly used in hospitals and tends to have a lower out-of-pocket cost. It is effective for many people.
- Zenpep is noted by some to provide better symptom control, but it can be much more expensive unless covered by insurance.

3. Managing Persistent High Output:
- While enzymes might not reduce watery output, taking Imodium (loperamide) about 15 minutes before meals that typically cause looser output can help decrease the volume.

4. Practical Tips:
- If there is impaired pancreatic function, such as partial pancreatic loss or complications from gallstones, taking the enzymes consistently three times a day is crucial for symptom relief.
- It is important to check the liver safety profile of these enzymes and discuss any concerns related to liver fibrosis with the prescribing gastroenterologist before starting the therapy.