Nutrition after a Whipple Procedure

Pancreatic cancer patients who undergo surgery for pancreatic cancer 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 surgery for pancreatic cancer 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 pancreatic cancer surgery:

• Take the prescribed amount of pancreatic enzyme replacement products will all meals and snacks.  After surgery, the remaining portion of the pancreas may produce little or no enzymes to digest carbohydrates, proteins and fats.

• A jejunostomy tube (j-tube), or a feeding tube, may be temporarily inserted into the digestive tract during surgery to help maintain and restore 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 and snacks daily to prevent feeling overly full.  Small meals are easier to digest.  Consider spacing meals 2-3 hours apart. 

• Drink at least 8 cups of fluids each day.  Lack of fluids may lead to fatigue, lightheadedness, and nausea. 

• Take small sips of liquids with meals.  Excess fluids at mealtime may limit solid food intake because patients may feel full quicker or may have increased nausea.  Large amounts of liquids taken with meals leave little room for solid foods that are rich in calories and nutrients.  Drink liquids an hour before or after eating to avoid feeling full.

• Drink beverages that contain calories, nutrients and protein, such as juices, smoothies or medical food supplements.  It is acceptable to drink these at mealtimes.

• Avoid alcoholic beverages.

• During periods of nausea, small bites of dry foods are often better tolerated than liquids on an empty stomach.

• Avoid eating concentrated simple sugars if symptoms of glucose intolerance or dumping are present.  Glucose intolerance symptoms include increased thirst, frequent urination, blurry vision and fatigue.  Dumping symptoms usually occur within 2 hours after eating and include flushed skin, dizziness/lightheadedness, weakness, abdominal pain, nausea, vomiting and diarrhea.

• 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. 

• If anemia occurs, ask the doctor if supplementing with iron or injections of vitamin B12 may be helpful.

• Keep a daily journal of the patient’s diet after surgery. In addition to the foods and the amounts eaten, also record daily weight, amount of pancreatic enzymes used, frequency and consistency of bowel movements and blood glucose readings (if applicable).  This information can be useful in tracking nutritional progress and can help the doctor or dietitian make further recommendations.

For more information about pancreatic cancer, including information about medical nutritional supplements, please contact a Patient and Liaison Services (PALS) Associate toll-free at 877-272-6226 or email pals@pancan.org.  PALS Associates are available M-F 7am-5pm Pacific Time.

The information and services provided by the Pancreatic Cancer Action Network, Inc. are for informational purposes only. The information and services are not intended to be substitutes for professional medical advice, diagnosis or treatment. If you are ill, or suspect that you are ill, see a doctor immediately! The Pancreatic Cancer Action Network does not recommend nor endorse any specific physicians, products or treatments even though they may be mentioned on this site. In addition, please note that any personal information you provide to the Pancreatic Cancer Action Network's associates during telephone and/or email consultations may be stored in a secure database to assist the Pancreatic Cancer Action Network, Inc. in providing you with the best service possible. Portions of the constituent data stored in this database may be used to inform future programs and services of the Pancreatic Cancer Action Network, Inc., and may be provided in aggregate form to third parties to guide future pancreatic cancer research and treatment efforts. The Pancreatic Cancer Action Network, Inc. will not provide personal identifying information (such as your name or contact information) to third parties without your advanced written consent.  100903