Whipple procedure: How to manage daily, chronic nausea and diarrhea?

Yes- tests were done. Thx

Same here tho the nausea vomiting has gotten worse for me in past 6 mos Whipple etc in 2021. Latest advise )yesterday)is that it’s very likely gastoparesis. Do to risks and side effects Trying first to handle with pot (tho smal dose faster acting). If that doesn’t work reglan (have had various advise on this to) and last option that I’m told will define work but I guess has more potential downsides, is olanzepine.

Im diabetic and was on metformin for years and had chronic diarrhea for years. After Whipple to remove a pancreatic adenocarcinoma I was switched to Nateglanide (starlix) and Tresiba and only occasionally have diarrhea when I eat too much natural sugar in fruit. I see a nutritionist in the oncology dept and highly suggest anyone who has had cancer of any kind will find their input beneficial. best of luck to you

Hello. I am dealing with the same thing after my Whipple surgery. I have tried various medications and OTC meds and no relief.

@ahmeachum Hi and welcome to Mayo Connect. What challenges are you facing post Whipple?

Hello. I am still dealing with vomiting bile. I vomit almost every day several times a day. I also have to immediately use the bathroom if I eat anything with grease. I do have a very hefty appetite. I eat and hungry about 10-15 minutes later I am starving. How about you?

@ahmeachum I haven't had a Whipple, though I do have pancreatic cancer. Do you take digestive enzymes? What have you tried to help with the vomiting and diarrhea?

I had the Whipple 3 weeks ago. The only time I had vomiting, (with extra sensitivity to all smells: perfumes, deodorant, etc. that did not help, but the nausea went away after a few days) was the first week post-op still in the hospital. I was prescribed a script for Ondansetron for nausea/vomiting that I did have to use a couple days last week. I tested myself on a food that I should’ve never had.

I’ve also learned that it matters immensely how well you chew your food and also incorporating foods like pineapple that help the stomach digest foods as it contains bromelain, papaya and other natural enzymes. These do not replace pancreatic enzymes but a good choice to add to meals. Not overdoing it with too many calories at one time is also recommended to avoid nausea and diarrhea, eating slowly, chewing thoroughly, and eating about six small meals a day.

After learning about the cost of Creon (even working with a Creon Ambassador) the cost is astronomical, my insurance was billed $4, 773 for 300 pills and over the maximum so was denied. I will refrain from expressing my opinion about this ludicrous cost and US pharmaceuticals. So, I sought recommended prescription alternatives, still too pricey.

Many use pancreatic enzymes with each meal. My particular surgeon never mentioned the need whatsoever nor did the hospital doctors. I am hoping to be in the 20% that do not need a lifelong prescription of pancreatic enzymes. What I did is find an over-the-counter pancreatic enzyme that I’ve tested out on eating pizza. It’s hard to tell if it was effective as I’m still having abdominal cramping that I believe is post-surgical related, with swelling on my left side between incisions in particular. I had a robotic Whipple, by a surgeon who has down thousands of Whipples, sometimes twice a day, and I’m still mind-boggled by this fact. My follow-up is this week.

As I’m only 3 weeks out and according to research, it can take months for the “new digestive system” to work out a new normal path for fats, nutrients, carbs, and proteins to be absorbed.

Yes, many need pancreatic enzymes. I’m hoping to maintain dietary alterations that I’ve chosen for myself to only need an over-the-counter prescription on occasion, food selection dependent. I’ve basically put myself on a diabetic diet, but will take an OTC pancreatic digestive enzyme before testing out, say, 2 ounces of steak. The Lipase in the over-the-counter is not anywhere close to what Creon contains. It is recommended to stay away from the types of steak that are marbled. From my understanding, if a person who’s had the Whipple decides to include saturated fats in their diet, animal fats, digestive enzymes would most likely be required.

I hope this information is helpful and wish you the best possible outcome.