A key characteristic of Peter's ΔF508 mutation is pancreatic insufficiency. That means that the pancreas ducts which conduct enzymes to the intestine are blocked by CF mucus. Normally-transmitted enzymes allow the body to absorb the nutrients from food, but CF-affected pancreases lack this basic ability. That is the main reason why CFers have so much trouble gaining weight. On top of that, the pancreas still makes enzymes, and those trapped enzymes slowly eat away and scar the pancreas because they can't get out.
From what I've gathered from the CF nurse practioner, Peter is very pancreatic insufficient. Peter is on the maximum dose for his pancreatic enzyme replacements (also called "enzymes"). He also takes two kinds of acid reducers, a medicine to increase appetite, and a medicine to decrease vomiting and help move food from his stomach to his intestines more quickly.
I called the "poop doctor"--the gastroentrologist--this morning and will see what she says needs to happen. I'm thinking Peter's going to have switch brands of pancreatic enzyme replacements. Either that, or we may have to add an additional medication to the combination we are already using. Please send good thoughts and prayers Peter's way. It's tough when you can't digest your food!
Over half of Peter's medication is to make up for his CF-related pancreatic insufficiency: 19-20 pills a day plus 3 oral solutions. He can't swallow pills yet, so we open the pills into applesauce so he can swallow the mini "beads" of medicine.
Thanks to "CF Mama" Kristina for posting this chart on her son's CF blog, Nathan's Fight. Source: Orenstein, David M., Cystic Fibrosis: A Guide for Patient and Family, 3rd Edition. New York: Lippincott Williams & Wilkins.
You might also be interested in reading about other CF families' enzyme brands/experiences on Bennett's blog or Breezy's blog.