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Nutritional counseling

and diet

Nutrition plays a major role in pancreatic diseases and after pancreatic surgery. The "pancreas" released into the small intestine contains numerous enzymes and ensures the absorption of fats, proteins, carbohydrates and vitamins. When the amount of pancreas produced decreases due to disease, after partial removal, or complete removal, this is called exocrine insufficiency.

It is important that sufficient pancreatic replacement enzymes are supplied to the body. It is important to take them at the same time as meals, not well before or after. The amount of pancreatic replacement enzymes should be increased in cases of diarrhea and decreased in cases of constipation. The frequently observed weight loss is not infrequently explained by the lack of ingested food, including insufficient intake of pancreatic replacement enzymes (food can then not be digested and absorbed by the intestine into the body). In addition, enough calories should be offered. This can be helped by changing the dietary rhythm from the classic 3 large meals to 6-10 smaller meals per day.

Basically, it is not necessary to do without certain food components. The perceived difficulty often lies in the consumption of fat. Then you can try to find a fat that is easy to digest. When increasing the amount of fat, one should start with small portions and increase them gradually. As an additional calorie carrier, one can consume medium-chain triglycerides (MCT fats) in the form of margarine or cooking oil. Pancreatic replacement enzymes can make up for this disruption in fat digestion. Smoking and alcohol intake can cause pancreatitis.

Unsafe absorption of fats very often also interferes with the absorption of fat-soluble vitamins, which require fats for absorption. It is possible to determine the levels of these vitamins (A, D, E, K) in the blood. If these vitamins are not in the normal range, they should be replaced.

Author: Benedict Kinny-Köster, M.D.