Diet after Whipple Procedure

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Question:

Is there a specialized diet recommended for people who have had the Whipple procedure for pancreatic cancer?

Answer:

A pancreaticoduodenectomy, or Whipple, is a demanding procedure. It involves the surgical removal of part of the small intestine, the pancreas, and sometimes part of the stomach. Therefore, it can alter the digestion of important nutrients and may change the rate at which food passes through the digestive system. As a result, patients who have had this procedure may need to make some dietary changes following surgery. These changes, along with the need to use pancreatic enzymes with meals and snacks, may be temporary or lifelong.

Each surgery is different because each patient’s disease status (e.g., location of the tumor, size of the tumor) is different. Therefore, each patient will have different nutritional needs. A Registered Dietitian (RD) can assist by monitoring your post-operative medical status, laboratory values, and reported symptoms in order to help create an appropriate diet for you.

General diet recommendations after this surgery include:

  • Eat 5-6 small, frequent meals during the day to ensure adequate nutrition
  • Choose foods high in protein and calories to help promote healing and maintain weight
  • Avoid large amounts of fluid with meals, as this may affect how much food you can eat. Small sips with meals are okay.
  • If you have gas, bloating, and/or diarrhea, pancreatic enzymes may be needed to help metabolize your food. Following a low-fat diet does not always solve the issues as it may already be difficult to eat enough to maintain weight after surgery. With the removal of part of the pancreas, pancreatic enzymes may be needed to help with the absorption of fat, carbohydrates, and protein.

After fully recovering from surgery, you may be able to slowly add back foods that you had previously been avoiding. These foods should be tried one at a time to determine if they are able to be tolerated. Many patients are also eventually able to eat regular sized meals.

Talk to your medical provider regarding pancreatic enzymes. The dosing of these enzymes may change as you begin to eat more, so be sure to keep your medical team informed about your intake and any new or unresolved digestive issues. Your enzymes may need to be adjusted depending on the amount and frequency of your intake. An RD at your medical center will be able to help you with the appropriate dosing.

Ask to visit with an RD to help with managing any diet restrictions. Appropriate diet management can help you to feel your best.

The original question and answer were generously donated by Diana Dyer, MS, RD a cancer survivor, registered dietitian, organic garlic farmer, and the author of "A Dietitian's Cancer Story: Information & Inspiration for Recovery & Healing from a 3-time Cancer Survivor."

Question and Answer updated by Jyoti Benjamin. MS,RD,CSO,CD on behalf of the ON DPG

References

Page updated: January 2014