Distal pancreatectomy ten weeks ago. Aside from the time before and after surgery, there have been no dietary restrictions. Generally, my diet is balanced. Using some digestive enzymes (Creon-10) experimenting with quantities (1 when starting meal 1 halfway through, 1 per meal, more or less). Additionally, using Metamucil powder before bedtime. Having 1-3 bowel movements daily some with slight oily film, some hard. Any suggestions for normalizing things (different enzyme strategy, fiber supplement, when to take) and expediting recovery process are greatly appreciated.
Posted: 07 Jan 2008 11:59 AM Originally Posted: 07 Jan 2008 12:00 PM
If you are a patient here at M.D. Anderson, I would highly recommend you schedule an individual consultation with one of our GI clinic dietitians to develop a more personalized plan based on your symptoms. However, I will outline some general recommendations here for your reference. While some patients are able to discontinue use of pancreatic enzymes after healing from surgery, others require ongoing use. Since the purpose of the Creon-10 is to aid digestion of fat, the number of pills you should take with meals/snacks may vary depending on the fat content of the meal. Dosing enzymes is more of an art than a science, but many of our pancreatic patients take 3 pills per meal and 1-2 pills per snack, adjusting for fat content of food as needed.
The oily film with stools usually means not enough enzyme was taken to digest the full amount of fat in the food. In contrast, constipation or very hard stools may be an indicator that too much enzyme was taken. Enzyme-related bowel changes are different that true constipation or diarrhea, and must be approached differently than these.
Separate from your pancreatic enzyme regimen, I would encourage you to consume the recommended 30 grams or more of dietary fiber daily. Ideally, this would be obtained from foods, but use of a daily fiber supplement is acceptable if needed as well. Remember that adequate fluid intake is also important to maintain bowel regularity.