2 years from pancreatectomy and can’t gain weight . Ideas?

Hello @gordond and welcome to Mayo Clinic Connect. It sounds as if you are concerned about your weight. Perhaps, if you share a little more, I can find others who can post with you. For example, after your surgery, did you lose a lot of weight? Did you have problems with appetite, or did foods not agree with you post-surgery?

In the meantime, there is one conversation on Connect which you might find helpful. Here is the link:
--How Do I Eat After Digestive Tract Surgery
https://connect.mayoclinic.org/discussion/how-do-i-eat-after-digestive-tract-surgery/
In this discussion group, you will meet with others who have had a pacreatectomy, a Whipple procedure, or colon surgery. I think you will find encouragement and helpful suggestions as you read these posts and post your own questions.

Will you continue to post and let me know how you are doing?

Dr. prescribes your replacement enzymes(Creon, Zenpep). They need to prescribe based on your pre-op weight. But if you were significantly overweight that may not happen. Your dosage can easily be changed. Ex: @180#. Max dose is 200000/ lipase per meal. From Creon site chart.

I was on 36000 and changed to 124000. I’ve never seen a chart on dosage. Thanks for the information

Chart might be in the “physician” area. I stumbled on it somehow. My Dr said starting with creon 3x36000 is a standard. It’s a good start for most with “major work”. The rest depends on your ideal weight and how you feel.

What. Does Creon have to do with weight? I can’t gain weight.

@gordond Simple fact- If you cannot digest food properly, you cannot gain weight. This is common for severe EPI if taking not enough Enzymes(Creon,etc.). Or your EPI very severe (pancreas removed).

What is EPI?, I’m on the 124000 Creon,

Exocrine Pancreatic Insufficiency... Pancreas does NOT produce enough enzymes to digest food properly/completely. As a result, In my case I got an intestinal blockages because I am not able to digest carbs and proteins. Fat enzymes are working good. Doctors were clueless, saying "just don't eat high fibre foods". But every time I ate a typical meal I was full in the first few minutes of trying to eat. I knew they were wrong because my diet has been the same for 30+ years and not high in fibre. A nurse practitioner had me do "the enzyme poop test". And I failed in a way doctors usually don't see. Typically EPI means being "low" on all three enzyme types and poop is very loose and very foul smelling when severe. Pancreas has 2 separate jobs. 1) regulating your blood glucose levels with insulin.(Note:glucose can be measured in most body fluids) and job 2) adding digestive enzymes to your small intestine at the exit of the stomach. W/O these enzyme you cannot extract vital minerals, vitamins and most calories from most food. If you don't get calories from food... gaining weight is difficult. The exception to this is fresh fruit and fruit juice, and you don't need the pills with EPI. Apples and bananas are my favorites. Pancreas removed ...makes you an EPI individual. Operated on for tumors also EPI, but how severe is determined by the "poop test". People with C.F. and long term diabetics have a higher rate of EPI than the general population. Welcome to the club.

Thanks for the infomation. Also does strength of Creon dosage help with weight gain?

Gordy

@gordond depends how much you eat... but yes if you are taking the proper(max) enzyme amount for your weight. It's your weight "W" / 2.2 ....x 2500 lipase. 180# person = 204,545 . I am 180# taking 200000 zenpep(40k x 5) and I always feel fine. I was on Creon 36000x 5 for while till they had a recall a few years back. Thus now on Zenpep