Microsoft word - pe16010whippleprocedurenutritionalconcerns.doc

WHIPPLE PROCEDURE – NUTRITIONAL CONCERNS
BEFORE YOUR SURGERY
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You are encouraged to eat a healthy, high protein diet prior to your surgery. A high protein diet consistsof leans cuts of meat, beans, peas, lentils, dairy, eggs, nuts, seeds, or protein powders.
Eating a high protein diet can lower your risk of complications and will promote healing after yoursurgery.
You should also eat fruits and vegetables every day.
AFTER YOUR SURGERY
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You should avoid high fat, greasy foods.
Try to eat several servings of fruit and vegetables per day Try to exercise for 30 minutes, broken up into 5-10 minute blocks.
WHAT DOES THE PANCREAS DO?
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Your pancreas is a large gland behind your stomach and close to your duodenum (small intestine).
The pancreas secretes powerful digestive enzymes that enter the small intestine through a duct. Theseenzymes help you digest fats, proteins, and carbohydrates.
The pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormonesplay an important part in controlling blood sugar.
WILL I BECOME DIABETIC?
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During the Whipple operation the head of the pancreas, is removed. Pancreatic tissue produces insulinthat is required for blood sugar control. When pancreatic tissue is removed the body releases less insulinand presents a risk of developing diabetes.
Patients who are diabetic at the time of surgery or who have abnormal blood sugar levels controlled by adiet prior to surgery have a chance of their diabetes becoming worse after surgery.
Patients who have completely normal blood sugar prior to surgery and no history of diabetes have alower chance of developing diabetes after surgery.
WILL I LOSE MY APPETITE?
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It is normal to have a lack of appetite after the operation.
Try to eat small meals of your favorite foods frequently throughout the day. It will take some time toregain lost weight.
It will take awhile to sort out which foods agree best with your body after this type of surgery. Somepatients have reported that it takes approximately 4 - 6 weeks or longer until they feel like their appetitehas returned to normal.
The main goal is to have a balanced diet with enough calories to prevent further weight loss and supporthealing.
WILL MY SENSE OF TASTE CHANGE?
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Patients also often report that they have a metallic taste to their food for the first few weeks. The use ofplastic or glass utensils will help decrease the metallic taste.
Foods may also have less taste. To increase your taste use tart flavors such as pickles, lemons, or vinegar.
Also trying new foods or foods previously disliked may be helpful.
To view: https://www.healthsystem.virginia.edu/intranet/per/To order: http://www.virginia.edu/uvaprint/ WHAT IS GASTROPARESIS?
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Gastroparesis is when the stomach takes too long to empty its contents. People with gastroparesis maycomplain of feeling full or bloated after eating. They may also complain of nausea with or withoutvomiting.
This occurs in up to 25% of patients after the surgery and it may take up to 4 - 6 weeks for the stomachto function normally. During this period you may not tolerate a diet very well.
You may need a medication such as Reglan to help your stomach empty during the first few weeks aftersurgery.
WILL I HAVE DIFFICULTY DIGESTING FOOD?
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The pancreas produces enzymes that aid in digestion of food. Removing part of the pancreas during theWhipple procedure can reduce the amount of enzymes that the pancreas makes. This can result in an oilydiarrhea or stools that float, abdominal pain, bloating, gas and weight loss.
If this occurs, your doctor can prescribe pancreatic enzyme replacement to take with meals. Severalpancreatic enzyme-replacement preparations are available, and they vary in the amounts of activeenzymes that they contain.
Pancreatic enzymes should be taken before each meal and snack.
The dose can be adjusted to achieve the best results.
As you start to eat more, you may need to take more pancreatic enzymes.
Tablets should not be crushed or chewed.
Pancreatic enzymes should not be taken with dairy products.
Pancreatic enzymes may be made with beef, pork, pineapple or papaya, so people allergic tothese foods should not take pancreatic enzymes.
Here are some suggestions for coping with diarrhea: Minimize raw fruits/vegetables that can be hard to digest Try foods such as applesauce, bananas and oatmeal Limit milk products if you have developed lactose intolerance Try to eat yogurt with lactase 2-3 times per day Drink plenty of fluids (6-12 cups of fluid per day) DO I NEED VITAMIN SUPPLEMENTS?
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We recommend that you take a daily multivitamin.
We also recommend that you take 500mg of Calcium with Vitamin D twice a day.
DO I NEED LIQUID NUTRITIONAL SUPPLEMENTS?
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Your doctor may recommend that you try liquid nutritional supplements if weight loss or malnutritionbecomes a problem for you.
Some examples are: Boost, Ensure, Carnation Instant Breakfast.
Diabetic supplements: Boost Glucose Control, Glucerna WHAT ABOUT WEIGHT LOSS?
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It is common for patients to lose up to 5 to 10% of their body weight after their surgery. This weight lossshould stabilize quickly, and after a few weeks should level out.
You should contact your doctor if you continue to lose weight after the first month.

Source: http://gwis.uva.edu/uvaprint/HSC/pdf/16010.pdf