Me too. And I weigh 95 pounds...I'm so looking forward to some help on this too. I'm gaining a bit of weight, but some is on the outside of my stomach; you know, the part you can grab with your fingers and measure. My Whipple was 1 1/2 years ago; I'm physically active, walking and household duties, gardening last summer.
I think it's gas; I've tried Gas X, etc. and no measurable results. Thank you for asking this question, Judith. Nothing like a skinny little old lady with a protruding stomach...but I'm glad to be alive and feeling good. Carrie

Since your Whipple procedure, were you evaluated for Exocrine Pancreas Insufficiency (EPI)? Resecting the head of the Whipple can remove as much as 82% of the acinar cells which produce and secrete the digestive enzymes. While some have sufficient cells left after surgery to handle their diet of carbohyd, protein and fat, others do not. And in those that have a sufficient amount, the remnant pancreas can atrophy so over time, the amount of digestive enzymes decreases. This results in undigested food mixing with intestinal bacteria, fermenting and causing excessive gas.

The test to determine if EPI is the cause is the Fecal Elastase1 test. It is a measure of the output,of enzymes by the pancreas. Values under 200 micrograms/gram stool indicates impairment and is treated with supplemental enzymes known as pancrealipase. Examples are Creon, Zenpep, Viokace and others. If you were prescribed a pancrealipase, then you may need to increase dosage to optimize for the fat, carbohydrate and protein content of each meal. The dosing calculator at https://digestthis.ca makes optimization easier.

If you eat high fiber vegetables and legumes, one’s pancreas does not produce the specific enzyme called alpha-d-galactosidase needed to digest oligosaccharides which are complex carbohydrates that comprise these food items. To prevent gas as a proactive method at the source, the OTC product Beano is the enzyme alpha-d-galactosidase. A capsule taken with a meal of high fiber vegetables such as corn, peas, cauliflower, Brussels sprouts, broccoli, cabbage, asparagus and all varieties of beans will prevent gas formation as opposed to simethicone-based products such as Phazyme and Gas-X. They work in a reactionary fashion after gas has formed to make it easier to expel. So if you want to prevent gas from forming in the first place, it requires having sufficient amounts of amylase, lipase, proteas and if your diet also contains any high-fiber vegetables and legumes, alpha-d-galactosidase as well.

Thank you for the information. I am taking Zenpep and will try adding another dosage. The calculator will be a big help as I have been dosing on my own as no one has told me what goes with what. They say what I am doing is ok, but I increased it myself and it did make a difference, but not touching the bloat.

Thank you again; I really appreciate it.

Judith

I had my Whipple six months ago. I have also noticed that certain foods give me more gas than others. Specially processed and high sugar foods. I have eliminated these from my diet and home cook most of my meals so I know how much fat I am eating. This has made a difference so far and I have not needed to take digestive enzymes.

That’s interesting. I stay away from processed foods as much as possible, I read every label and no sugar in food more than 2 grams.

I wasn’t given enzymes when I left the hospital and it was awful. Diarrhea constantly. I have improved since then (two years ago), but I am still not regular. Of course, I am on enzymes now, but the balance is probably off. You are very lucky not to be pinned down with enzymes.

I'm hesitant to advocate a medication, but about 2 months ago I saw my PC complaining about diarrhea, gas, etc. and she prescribed cholestyramine, a powder mixed with water or juice. I think it is old fashioned bile salts, seems to regulate digestion, little or no side effects. It has helped me immensely, especially the diarrhea and of course some weight gain. As long as others are offering some medication help, I thought I would mention this low-key help. Good for you, carfbuch --so glad diet control works so well for you!

Back before my tumor was found or even before I discovered that fat was causing my steatorrhea my gastro put me on Dicyclomine for gas and gas pain. I am still on this and most likely will be forever. You and yours may differ. Just passing on my information.

Best wishes to everyone dealing with cancer.

Thank you for that information.

Judith