Post Whipple: how long before your stomach "woke up"?

Hello Caryn: I am a pancreatic and breast cancer survivor and Registered and Licensed Dietitian (still practicing) in our state (MN.) Here is the short story. (Please let your MDs guide you.) I took Creon, a pancreatic enzyme, each time I ate, per my MD orders. Be sure to follow the medication direction, if your MD prescribes this med. I ate a lot of fast digesting carbohydrates, read that to mean "a lot of sugar containing" foods. Odd for a dietitian, but I could digest them without much difficulty. Eat small meals. Don't overload with fiber and/or volume of foods, including fiber. I had to eat what I could tolerate. Stay hydrated. Eat adequate protein. (Think about using a supplement, such as Boost, etc.) I do not work for any medical nutritional company and am not promoting one product over the other. Try and see what you like and can tolerate. The process of the gut adapting will take time. Be patient and pat yourself on the back a lot. At almost 15 years out, I see a Mayo Gastroenterologist for guidance. I also use my experience as a Dietitian to help me. There are other things I can teach you, but I don't want you to be overwhelmed. Just take it very easy, please. And here is to your good healing. Mayr Boros, RDN, LD.

@caryns If there's an issue getting a prescription for Creon ( or the cost is too high), our nutritionist recommended an alternative from Vital Nutrients. We haven't tried it yet because our insurance has been covering the Creon so far. (3 x 36000 unit Creon 3x/day is retail $12000 per quarter!) The Creon manufacturer Abbvie also has a coupon for $5 copay but cannot be used by Medicare patients. Good luck. Dosing for Creon is going to be trial and error and the amount you need might change over time.

Please do continue to post on nutrition as itis important to every step in our fight against cancer to maintain good health and spirit.

Thank you, Caryn. If I can help out, I am happy to. Take care.

I'm on TPN and hardly eating or drinking anything by mouth because of nausea and DGE. I take Reglan and Protonix daily but I might eat once a day, something small. I can't drink much either. Tried Boost and Carnation Instant breakfast but don't like the texture or sweetness. Prefer more watery fruits like watermelon but even then can't eat more than a few bites.

Everything I read says eat 5x a day and eat protein with each small meal and drink a lot, but I can't do any of this. I talk to my surgical team and am told it's normal (I had IORT and also a vein replacement). Should I be too concerned about this?

Try to eat a couple of saltine crackers with peanut butter on them several times a day. The crackers help settle the stomach and the peanut butter gives you protein. I took me 3-4 weeks but it will get better. Drink some 30 gram protein drinks even if just a swallow or two at the time. The best to you.

Hello @caryns

It sounds as if you have been through quite a bit and I can certainly understand your concern about not being able to eat very much. I'm guessing that you have lost a lot of weight and might be feeling very weak and fatigued, as well. Is that the case?

While I've never had a Whipple surgery, I have had several surgeries of the upper digestive tract to remove carcinoid (a rare form of cancer) lesions. I also had a difficult time eating after the surgeries. How long ago was the Whipple procedure?

There are many members in the pancreatic cancer group who have had Whipple surgeries, perhaps not extensive as yours, but I would like to invite @marvinjsturing to this discussion.

You mention having difficulty drinking some of the liquid protein drinks because of the sweetness and texture. Are you aware of a product called Boost Breez? It is not a milk product so you might find it easier to drink. Another member of Connect, @thull, has had multiple surgeries for diverticulitis and she has mentioned this product. She prefers the peach flavor. In the past, it could only be ordered online and was not available in stores. I'm not sure if that is still the case,

If your medical team says that this is a normal response from the surgery, you may ask for a referral to a registered, certified dietician at your medical center. They are very helpful in tailoring eating plans for people who have had digestive tract surgeries such as yours.

After my second intestinal tract surgery, I met with a dietician and she gave me some very helpful ideas. Have you conisdered asking for a referral to a dietician?

Sorry, I can't provide any experience with TPN.

My wife had IORT and also needed to eat 5-6 small meals per day post distal pancreatectomy. Did they also take your gall bladder?

Hello @bb21

I appreciate your input about eating after Whipple surgery. How long ago was your surgery?

Are you able to eat more normally now or do you still have restrictions as to the amount and type of food you can eat?

Thanks @beachdog for your response.

Yes gall bladder is gone as well. I might mention that my liver enzymes are pretty high but since last year when I was diagnosed with jaundice they've been that way. I did neoadjuvant chemo and radiation and I recall thatduring the radiation treatments my liver enzymes were high too. Wondering if my liver issues might be contributing to the dietary ones?