Nutrition
Following a Whipple Procedure
Pancreatic cancer patients
who undergo the Whipple procedure often have many questions and
concerns regarding post-operative nutritional care. First and foremost,
patients and their caregivers should understand that each patient
has individualized nutritional needs. All patients should consult
with a registered dietitian or doctor prior to making any changes
to the diet and to create an appropriate dietary plan.
Typically, after a Whipple
procedure the patient's diet should not include large meals or fatty
foods. A low fat diet of 40-60 grams of fat per day may be necessary
on a long-term basis. In addition, drinking a small amount of fluids
with meals may help prevent bloating, high gas production, abdominal
cramping, and diarrhea.
These are a few diet recommendations
following a Whipple procedure:
- A jejunostomy tube (j-tube), or a feeding tube,
may be temporarily inserted into the digestive tract during surgery
to help maintain and restore an optimal nutrition.
- Gradually work back to an oral diet of solid foods.
The timing of this varies from individual to individual.
- Avoid high-fat, greasy or fried foods.
- Increase the intake of nutrient-rich foods.
- Eat 5-6 small meals daily to prevent feeling overly
full. Small meals are easier to digest. Consider spacing meals
2-3 hours apart.
- Drink at least eight cups of fluids each day. Lack of
fluids may lead to fatigue, lightheadedness, and nausea. Drink
liquids an hour before or after eating to avoid the feeling of
fullness.
- Take small sips of liquids with meals. Excess fluids
at mealtime may limit food intake because patients may feel full
quicker or may have increased nausea. Large amounts of liquid
leave little room for solid foods that are rich in calories and
nutrients.
- Drink beverages that contain calories and nutrients.
It is acceptable to drink these at mealtimes.
- Avoid alcoholic beverages.
- During periods of nausea, dry foods are often better
tolerated than liquids.
- Avoid high intake of concentrated simple sugars
if symptoms such as high thirst, frequent urination, fatigue,
flushed skin, dizziness/lightheadedness, weakness, abdominal pain,
nausea, vomiting, or diarrhea are present.
- Consider taking a multi-vitamin or individual vitamin
supplements. Calcium and the fat-soluble vitamins A, D, E, and
K may be necessary if fat malabsorption-induced diarrhea is present.
Ask a healthcare professional for a proper dosage of individual
vitamin supplements.
- Ask the patient's physician about supplemental injections
of vitamin B12 to avoid anemia.*
- Take the prescribed amount of pancreatic enzyme
replacement medication with all meals and snacks. After surgery,
the remaining portion of the pancreas may produce little or no
enzymes to digest carbohydrates, proteins, and fats.
- Consider using protein and energy dense oral supplement
drinks containing Medium Chain Triglyceride (MCT Oil), Eicosapentaenoic
Acid (EPA), and Fructooligosaccharides (FOS) fiber. These supplements
may promote weight gain and may help increase strength, physical
activity, and quality of life.*
- Keep a daily journal of the patient's diet after a Whipple
procedure. This can be useful in keeping records of nutritional
progress.
* For more information
on pancreatic cancer, including medical nutritional supplements,
please contact a PanCAN Patient and Liaison Services (PALS) Associate
toll-free at (877) 272-6226 or email pals@pancan.org.
PALS Associates are available Monday through Friday 8:00 am to 5:00
pm Pacific Time.
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