Help take pain out of pancreatitis with your diet

by Columbia Surgery on April 11, 2013

Deborah Gerszberg, RD, CNSC, CDN
Clinical Nutritionist, The Pancreas Center

“What can I eat?” This is a popular question asked by those suffering from chronic pancreatitis or who have experienced acute pancreatitis and would like to do everything in their power to prevent another attack.

156216964First, let’s make sure everyone understands what pancreatitis is. Pancreatitis is inflammation of the pancreas and is usually very painful. The pancreas releases excessive enzymes and basically begins to digest itself. In order to heal, many patients must follow a liquid diet. Sometimes patients must avoid taking liquids by mouth. If you are suffering from an acute episode of pancreatitis, it is very important to call your doctor and follow their instructions. Sometimes hospitalization is necessary.

Now let’s discuss the diet for chronic pancreatitis. It is most important that you understand what not to eat and why. There are a few things you must completely avoid, such as alcohol and fried/greasy/high fat foods (such as creamy sauces, fast food, full fat meat and dairy, and anything fried). These foods can cause your pancreas to release more enzymes at once than it normally would, leading to an attack. There are also foods that you should eat only sparingly, if at all. These include refined carbohydrates (white bread, sugar, and high fructose corn syrup) which cause your pancreas to release more insulin than more wholesome complex carbohydrates (such as whole grains, fruits, vegetables, and legumes). In general, I recommend minimizing processed foods, which are either high in fat, high in refined sugars, or sometimes both.

You may be surprised I didn’t say to avoid foods containing fat. This is usually unnecessary and also unhealthy for most people suffering from chronic pancreatitis. You should aim to have a “moderate fat diet,” in which about 25% of your calories come from fat. For a 2000 calorie diet, this would be 55 g fat/day. In addition to adhering to a moderate fat diet, try to have small, frequent meals, which are easier to digest than having large meals, which may precipitate an attack.

The best food choices for those suffering from chronic pancreatitis are fruits, vegetables, whole grains, legumes, and nonfat/low fat dairy, and lean cuts of meat. Healthy fats such as avocado, olive oil, fatty fish, nuts, and seeds, may be consumed with careful portion control. Therefore, consume these healthy fats in small amounts. See Table 1 for serving sizes of typically high fat foods. I do not encourage eating everything on the list; use it more for informational purposes. If you are unsure of how much fat a food contains, you can access the USDA National Nutrient Database at http://ndb.nal.usda.gov/.

Everyone’s diet is very individualized, depending on age, weight, food tolerance and preferences. Therefore, if you have further questions about your diet, I encourage you to seek the assistance of a Registered Dietitian (RD). You can find a local RD by visiting the Academy of Food & Nutrition’s website: http://www.eatright.org/iframe/findrd.aspx.

If you are a patient of The Pancreas Center, feel free to make an appointment with me directly: http://www.columbiasurgery.org/patient/pancreas_nutrition_counseling.html.


Table 1: List of fat containing foods, 5g fat per serving:

Serving Size Food
1 tsp Oil(vegetable,corn,canola,olive,etc.)
1 tsp Butter or margarine
1 tsp Mayonnaise
1 Tbsp Reduced-fat margarine or mayonnaise
1 Tbsp Salad dressing (average brand)
1 Tbsp Cream cheese
2 Tbsp Lite cream cheese
2 Tbsp Avocado
8 large Black olives
10 large Stuffed green olives
1 slice Bacon
1 medium Whole egg
3 oz Wild salmon (farmed salmon has twice the fat)
1 ½ tsp Nut butter

 

Adapted from: https://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/fd_exch.htm#8
Choose Your Foods: Exchange Lists for Diabetes pamphlet, The Nutrition Care Manual


{ 46 comments… read them below or add one }

Jeanne G. June 13, 2013 at 10:04 am

Dear Deborah,
Thank you so much for this article, it had a lot of the answers I have been looking for.
The fat tablet is so helpful and the amount of fat intake a day is so helpful.
Finally I can chart a course for my husband’s diet.
He needs surgery fo kidney cancer but they don’t want to touch him till pancreas
calms down.
We are going to commit to a pancreas diet and the foods that can help calm down his
Pancreas.

Columbia Surgery June 13, 2013 at 11:18 am

Thank you, Jeanne, for your kind words. I have forwarded your comment onto Deborah and she wanted me to pass along the following message:

Jeanne – I’m so glad to hear this blog was helpful for you and your husband. I wish him the best of luck with the upcoming kidney surgery.

Jeanne G. June 13, 2013 at 11:30 am

Thanks for the response I have given my husband Tom the phone number to call
and discuss his situation . It would really be helpful to have someone to talk to about his
condition.
Thanks,
Jeanne

Eva August 10, 2013 at 11:12 am

I was released a few days ago from the hospital after an severe acute attack of pancreatitis. I was hospitalized for a week, but left with very little information, a lot of pain, and a distended stomach (I look 6 months pregnant). No one seems to be able go give me any info as to what to do, what to eat, or when it may get better. I feel like I am at the end of my rope. any suggestions would be appreciated.

Columbia Surgery August 12, 2013 at 3:30 pm

Hi Eva,

I forwarded your comment to Deborah Gerszberg, RD, CNSC, CDN – Clinical Nutritionist at The Pancreas Center. She has replied with the following:

Eva, I am sorry you are going through such a hard time. Do you have a doctor who specializes in pancreatitis? That would be the best person to contact to answer your questions. If you do not have a specialist, I would recommend seeing one of our doctors, who may be able to give you some guidance. Without access to your medical records, it would be a disservice to you to offer blind nutrition advice. I hope you feel better soon!

For more information about the Pancreas Center, please visit: http://pancreasmd.org or contact the New Patient Coordinators Lynette or Priscilla at 212-305-9467.

sojitrichur August 20, 2013 at 9:33 am

Very deep educated lesson.

Arindam M. August 29, 2013 at 4:49 am

Thank you for your guidence, I will follow the diet chart and will intimate you my recovery status later.

heather September 26, 2013 at 12:02 pm

My husband has chronic pancreatitis with terrible diarrhea. I’m trying to find low fat recipes to help with this. I have a lot of great vegetarian recipes that include beans, lentils and chickpeas. Would that exacerbate the diarrhea, or help since it’s low fat??

Columbia Surgery September 27, 2013 at 10:24 am

Heather,

Thank you for reaching out to us. I have forwarded your comment to Deborah Gerszberg, RD, CNSC, CDN, Clinical Nutritionist at The Pancreas Center and she has responded with the following:

“Beans, lentils, and chickpeas are gas producing and high fiber foods which may exacerbate diarrhea, depending on the cause of the diarrhea. Without having done a full assessment on your husband, I cannot give personalized recommendations. However, if your husband has chronic pancreatitis and is having terrible diarrhea, it sounds as though he may be malabsorbing his foods. This may be due to pancreatic insufficiency, due to damage to the pancreatic tissue. If this is the case with your husband, he would need to take pancreatic enzymes with all meals and snacks, and the diarrhea should stop with a therapeutic dose. All of the FDA regulated enzymes are prescription only, so I would encourage your husband to see a gastroenterologist specialized in treating pancreatitis and see a regisitered dietitian to help develop a personalized meal plan.”

I hope this information helps. If you are interested in seeing a GI specialist here at The Pancreas Center, please call 212-305-9467 or visit http://sklad.cumc.columbia.edu/surgery/pancreas/appt_request.php. Best regards.

Mikaela g November 11, 2013 at 11:08 pm

Thanks so much for this, I am fourteen and have suffered with pancreatitis since I was nine. I was hospitalized for two weeks at the age of ten and I had my gall bladder out last year and thought that I would be good this year, but no. I am currently struggling with pancreatitis so I’ll give this a go.
Thanks heaps
Mikaela

Dharaneetharan November 23, 2013 at 8:53 am

Thanks for your valuable information…. i had lot of doubts about the diet… now it is very clear about what to do..

Janelle December 2, 2013 at 11:44 pm

Thanks, I needed this. I’m pregnant, again, with my third child. During my second pregnancy I had a severe case of pancreatitis. I was hospitalized for a month. I ended up having an ERCP done. I’m starting to have nausea now and I’m so afraid that I will have another case of pancreatitis. Thanks for the chart.

Columbia Surgery December 3, 2013 at 11:28 am

Janelle – We’re glad to hear this article was helpful and thank you for sharing your story. Wishing you and your family good health.

Dale December 5, 2013 at 4:36 am

Hi
I had acute pancreatitis about 16 months ago. My lipase was over 5000 but they said it was still mild as there was no long term damage. I had an EUS and autoimmune tests but they can’t find the cause so are presuming it was a virus. I have been following a lowish fat diet, I never have more than 10 grams fat per meal and don’t eat any more fat until at least two hours after. I have also stopped drinking alcohol apart from one glass once and a few sips every now and then. I don’t mind if I don’t drink again but would like to loosen up my diet a bit so I can’t eat at friends houses or restaurants more easily. How long do I need to restrict fat ( my diet was always pretty good day to day) or should I stay on this diet for good. Thanks

Columbia Surgery December 5, 2013 at 11:45 am

Hi Dale,

I have forwarded your question to the Pancreas Center, who would be best able to answer your question. As soon as I hear a response, I will reply.

If you are interested in arranging an appointment, we always encourage our followers to reach out to the center by calling: 212-305-9467. More information about the Pancreas Center can be found at: http://pancreasmd.org Thank you.

Ron C. December 10, 2013 at 3:29 pm

Very helpful, but still need a diet. I have had acute pancreastitus for over 5 yrs. 1 yr ago I had my gall bladder taken out. Didnt help, had another attack last wk. Do NOT drink, or smoke. Eat fairly healthy. I would like a good diet. Thanks, Ron

Columbia Surgery December 10, 2013 at 3:38 pm

Hi Ron,

Everyone’s diet is very individualized, depending on age, weight, food tolerance and preferences. Without an examination from our medical team, it would be a disservice to offer you additional advice. If you would like to contact our center to arrange an appointment, please call our new patient coordinator at 212-305-9467. More information about the Pancreas Center can be found at: http://pancreasmd.org

Tony R. January 24, 2014 at 2:44 pm

I have been suffering from chronic pancreatitis symptomes for two and a half years now with no diagnosis. I have seen countless doctors and GI specialists, I have had multiple CTs, US, MRIs, and blood work all have been negative. I am relieved at the test results but still have pain shortly after eating, especially fried or heavy fat foods. The pain I have is in the same pattern as described for pancreatic pain. I have started to follow a pancreatic diet with good results so far. What do my negative tests indicate in the presence of my symptomes?

Tony R.

Rannie M. January 25, 2014 at 12:12 pm

Hi,
Previously hospitalized (one week) for Pancreatitis and just recently for one night.
I am alcoholic; however, I am able to abstain for periods of two to four months. Apart from “getting treatment” is there anything else I can do to avoid the next episode.
Thanks for your advise.
Rannie.

Columbia Surgery January 28, 2014 at 11:43 am

Rannie, I am sorry to hear about your current situation. Unfortunately, without an examination from our team, we cannot offer the medical advice you seek. If you would like to arrange an appointment, please contact our new patient coordinator at 212-305-9467 or visit our website, pancreasmd.org. Thank you.

Columbia Surgery January 28, 2014 at 11:48 am

Hi Tony, thank you for reaching out to us. I am sorry to hear about your frustrations. If you are not taking pancreatic enzymes (by prescription only), it sounds like you may benefit. Please check out Deb’s recent blog article about pancreatic enzymes here: What You Need to Know About Pancreatic Enzymes. Again, please note it’s by prescription only, so be sure to talk to your medical team if this is a right option for you.

Unfortunately, without an examination from our team, we cannot offer the medical advice you seek. If you would like to arrange an appointment, please contact our new patient coordinator at 212-305-9467 or visit our website, pancreasmd.org. Thank you.

DEBBIE February 7, 2014 at 4:34 pm

im trying tofind out what foods my sister can eat with pancreatits..what can she eat that wont cause her to hurt or be sick…..please help me…so i can shop and cook to keep her healthy and as pain free as possible…thank u

Columbia Surgery February 7, 2014 at 4:42 pm

Hi Debbie,

I am sorry to hear about your sister. Unfortunately without a complete medical examination, we cannot offer the advice you seek. If you would like to arrange an appointment with the Pancreas Center, please contact our new patient coordinator at: 212-305-9467. Thank you.

DEBBIE February 7, 2014 at 5:44 pm

ok thank u..she is just visiting here…cuz our dad is sick..was hoping u could give me some ideas of what would be healthy for her….

joe b. February 7, 2014 at 8:37 pm

I went in the hospital last year having serious abdominal pain. I was bright yellow, bloated and vomiting blood. I woke up almost a month later. All my organs shut down and i went into a coma. I was on life support for two weeks.I was diagnosed with chronic pancreatitis. Almost a year later now im in severe pain everyday and deal with neasea on a daily. I see a gi doctor once a month and have had many tests done. Im outta ideas and options! Is this ever going to go away or is this for a lifetime?I need help, i cant deal with this anymore! BTW march 1st will be one year completely sober from alcohol. I was 28 years old when this happened last year, the worst case my dr has ever seen especially for my age!

Diane February 8, 2014 at 11:37 pm

I was diagnosed with chronic pancreatitus,scarred and shrunken after ERCP,second time with bacterial overgrowth, after breath test in Aug.2013,was given antibiotics.Pain,nausea after food intake,diarehea ,etc starting to have same symptoms ,,.Bloodwork has elevation of calcium,and sugar.Dr. Has given me pancreatic enzymes,since May 2013,was told not reversible , B-12 deficiency,too mant syumtoms,starting to loose hope.Poor quality of life,getting depressed .

Columbia Surgery February 10, 2014 at 11:51 am

Hi Debbie,

This article you’ve commented on gives general guidelines for a diet appropriate for pancreatitis (Help take pain out of pancreatitis with your diet). As a person’s diet can be very individualized from personal preference, to allergies, and dietary needs, it would be a disservice to offer personalized advice for your sister. We would be more than happy to facilitate an appointment if she is interested in seeing our center for more information. Wishing you and your family good health.

Columbia Surgery February 10, 2014 at 11:54 am

Hi Joe,

I am sorry to hear about your situation. Unfortunately, without a medical examination from our team, we cannot offer the advice you seek. If you are interested in arranging an appointment with The Pancreas Center, please call our new patient coordinator at 212-305-9467. Thank you.

Columbia Surgery February 10, 2014 at 11:56 am

Hi Diane,

I am sorry to hear about your situation. The Pancreas Center Clinical Nutritionist has written an article about pancreatitis and enzymes. You may read it at: What You Need to Know About Pancreatic Enzymes. Beyond this, I am sorry but unfortunately we cannot offer you advice without an examination from our team. If you are interested in arranging an appointment with The Pancreas Center, please call our new patient coordinator at 212-305-9467. Thank you.

Ricki L. February 13, 2014 at 8:56 pm

Wow, thank you! I wish I’d seen this article last summer when I was first sicken by an ERCP. They never found anything wrong with me but the dye caused a massive reaction and my lipase was 111,000. Yes, over 100,000. I’m lucky to be alive but have been left with complications.

Now I’ve dealt with major pancreas and nutrition problems ever since and it’s turned my whole life upside emotionally, financially, and physically. Dealing with the food challenges, I’ve avoided social events and eating out anywhere the past six months (and my poor family by default) out of fear. Plus, our society celebrates everything with food and/or drink and it’s depressing to watch everyone be carefree while I eat a dry, boring overpriced salad or not at all.

This article will make it easier to figure out my overall options – I’ve only been eating maybe 20 grams of fat (and dealing with mood/depression issues) and too many carbs (trying to quell my hunger pangs). It’ll be so much better to have some flexibility and even eat small amount of the healthy foods I miss, like nuts and avocado. Ironically, I ate much healthier and balanced before this whole mess – a followup surgical specialist said my fitness and nutrition level probably saved my life during this catastrophic ordeal.

I sure hope my pancreas recovers eventually since it’s made me very angry to be MADE sick by a doctor. I could accept it better if I was doing something unhealthy or my body was defective in some way.

Good luck to my fellow survivors!

Kelly March 4, 2014 at 7:58 am

Hi, I just recently had a second bout with pancrentitis. They seem to have no answers to why this has happend, or happend again. I have been home for 5 days and have had 2 serious pain attacks. Which I stand, use heating pad and pain med , for now. Because last night that was the last pain med I have , they gave me 10 to take every 12 hrs. I go for a follow up Thursday 3/6. But I’m scared they will not continue pain meds, what I had the first time to eat was a sandwich, which I though ok, you probably had something to heavy for yourself, but last night I had a bowl of cereal, which never ever bothers me, I was in serious pain. I also should include I suffer from IBS, gerd. So a lot of times I feel I’m battling the pancreas against the IBS. They didn’t prescribe enzymes which really bothers me. I am a very small person to begin with, can’t afford to loose weight. I am not a drinker, I use to be. I may have a glass of wine once on awhile. But that is completely out of the equation.. I just don’t know if the pain I had felt was my pancreas telling me , atupid I’m not ready for that I’m still healing. Or the things I had or things of the past for me to eat.. Thx for your information or any you maybe able to give regarding this message….

Columbia Surgery March 4, 2014 at 10:16 am

Hi Kelly,

I am sorry to hear about your struggles. Unfortunately, without examining your records, we cannot offer any medical recommendations. If you would like to make an appointment with our team at The Pancreas Center, I encourage you to call our new patient coordinator at: 212-305-9467. If coming in person for an evaluation would be difficult, please note we have arranged with previous patients to work with their local team of doctors for second opinions. Please call for further information.

Also, I know you mentioned being interested in pancreatic enzymes. While we cannot comment whether they would be beneficial to your situation, we have a blog article which may give you more information about them. You may find it at: What You Need to Know About Pancreatic Enzymes. Wishing you the best in your recovery.

Mayank March 5, 2014 at 12:45 pm

I hav encountered dis pancreatitis monster thrice now.. Got discharged from hospital a few days back n still on a liquid diet. I m 25.what i wana know is if there is a permanent or a long term stay to this or not as it(acute pancreatitis) happens almost after every year.in a span of 1 year i have been sober,sure have been eating fatty food but also not that often also please suggest when shall i start taking solids as its been 3-4 days now that i got discharged from d hospital

Columbia Surgery March 5, 2014 at 1:50 pm

Hi Mayank,

I am sorry to hear about your struggles, but thank you for reaching out to us. Unfortunately without an examination from our team, we cannot offer you the medical advice you seek. If you would like to see a doctor at The Pancreas Center , I encourage you to call our new patient coordinator at 212-305-9467.

Bahvihn March 13, 2014 at 11:41 am

Hi , This is my third encounter with Pancreatitis in just 5 months.it never happened ever before. Please suggest is there any chances of recovering back to 100% fit.

Columbia Surgery March 13, 2014 at 12:47 pm

Bahvihn,

Thank you for sharing your story. Unfortunately without a complete examination, we cannot offer the advice you seek. If you would like more information about The Pancreas Center, please visit our website at The Pancreas Center or call our new patient coordinator at: 212-305-9467. Thank you.

Alfredo March 15, 2014 at 2:06 pm

I have lost over 85 pounds much of it by choice. several doctors have not helped and not provided any info after four attacks of pancretitis. My one internest suggested an MRI and found a spot on my pancreas. After referral to a speciist and biopsy determined chronic pancretitis and also prescribed an enzyime to gain weight. you artice on nuetrion has also been of great help. I recommend seeing a specialist and not wait on what generalist say. seek a specialist after the first attack and be proactive for you health.

Columbia Surgery March 17, 2014 at 10:01 am

Alfredo: Thank you for sharing your story! Seeking a specialist’s help and being proactive with your health is great advice.

Angela L. March 20, 2014 at 3:26 pm

My husband has chronic pancretitis and also is on dialysis post liver txp. I am at a loss for everything. Please help me help him deal with this pain.

Columbia Surgery March 20, 2014 at 3:50 pm

Hi Angela,

I am sorry to hear about your husband’s struggles, but thank you for reaching out to us. Unfortunately without an examination from our team, we cannot offer you the medical advice you seek. If you would like to see a doctor at The Pancreas Center , I encourage you to call our new patient coordinator at 212-305-9467.

ALFRED March 22, 2014 at 1:15 am

Dear Doc. First please excuse my spelling , I have acute cronick pancreatitis divisiom. I have been dealing with this for the past 16 months. The last 6 months have been nothing bet pure hell for me, I go to the Doctor every other month and have stents put in and removed . I have lost 42 pounds of weight. They want to do a WHIPPLE SURGERY on me. Because of the loss of weight they want to put a feeding tube inside me. I have just quit smoking 77 hours ago. I told them to give me 45 to 60 days to put on weight. I also have cancer ( squimish cell casanover ) , Hep. C , diabieties , COPD, the list is quitt long there is more but cant remember right now. They say on a somewhat healthy person the Surgrey is 50 – 50 on a not so healthy person 65 – 35 on me 75 – 25 to make it threw . The odds suck to be honest. I’m really afaried to let them do this to me. Thank you . Sincerly Alfred V.

Columbia Surgery March 24, 2014 at 9:57 am

Hi Alfred,

I am sorry to hear about your struggles, but thank you for reaching out to us. Unfortunately without an examination, we cannot offer you the medical advice you seek. If you would like to see a doctor at The Pancreas Center , I encourage you to call our new patient coordinator at 212-305-9467. If it is difficult for you to come in for an appointment, we have arranged with previous patients to work with their local team of doctors to complete initial evaluations. If this interests you, please contact The Pancreas Center’s new patient coordinator for further information. Thank you.

Kevin Coffman April 4, 2014 at 9:30 pm

Hi, I have had servere chronic pancreatitus for 27 years. I am 37 and believe me I have had many trial and errors. Enough pain for three life times. Nov 23 2012 I had the worst attack of my life and it took me almost a year to get my weight back on and live a normal life. I thought I was going to die. I have a 5 year old son and I made many promises to God and My self (as we all do when we are in trouble) but this time I meant it. I have not smoked, drank, or ate to many things that am not supposed to since Nov 24 2012. I have always exersised but with the help of enzymes, eating several small meals a day the right kind of pain management I have never had such a great out look of life. I still have attacks and it can be very depressing. I wanted to share this because I know that if you buckle down and do the things you know you are supposed to do ( especially when you are feeling good) you can limit the attacks and live a full life. Fuller then most since we have to eat so darn healthy. Good luck to you all and keep your head up.
KEVIN

Columbia Surgery April 15, 2014 at 10:04 am

Hello Alfred, I am sorry to hear about your condition, but thank you for reaching out to us. Unfortunately without an examination from our team, we cannot offer you the medical advice you seek. If you would like to see a doctor at The Pancreas Center , I encourage you to call our new patient coordinator at 212-305-9467.

Misty Rose April 16, 2014 at 3:04 am

I’m a 27 year old who was diagnosed with chronic pancreatitis in 2012, I take creon 24,000 units 3x a day. I have developed severe IBS from all this that goes from one extreme to the next. I am at the stage where I can manage my weight steadily, but still sit at a little over weight side. My issue is that I cant depend on anything that I eat. for example I can eat a banana one day and be just fine, but the next one could make me doubled over in pain for the day. it’s like this with several foods. I constantly feel like I’m playing with fire with everything I eat. I do know all the donts when it comes to this topic no fatty, greasy, fried foods, no alcohol, or tobacco…. I’m just so lost with the dieting and don’t know where to go from here, its frustrating and disappointing that I’m trying my best to be healthier and make better choices, but that’s not even good enough. Anything for advise, info, help would be very much appreciated. This is recently starting to make me feel like I’m failing and trying so hard at a battle that I cant win. I cant afford the GI doc visits anymore, along with the creon med itself.
thank you for your time……..

Columbia Surgery April 16, 2014 at 12:06 pm

Hello Misty, thank you for reaching out, and I’m sorry to hear about your condition. Unfortunately, providing you with an accurate recommendation would require an in-person consultation with one of our doctors. If it’s possible, I encourage you to call our Pancreas Center at 212-305-9467 to setup an appointment. You can also visit the Pancreas Center website at http://http://pancreasmd.org/

Leave a Comment

Previous post:

Next post: