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What to eat during a pancreatitis flare?
By sankey on Saturday, February 12th, 2011 | No Comments
There are certainly some very tough situations for some people.
Recently heard from M who wrote about not being able to afford ER
support for a recent flare of pancreatitis. M wrote:
"I was first diagnosed with Pancreatitis just before my wedding in
August of 2010. The only relief was my week in the ER on fluids in my
IV and a serious of pain and sleeping pills.
Now I have a horrible flair up and can't afford to go to the ER for
another week as I am still paying on the old bills.
Does it help to eat the yogurt/jello while you have it or do you have
to stop all food intake until the pain subsides? This just doesn't
feel like it would be healthy at all.
I think my sickness must come from a combination of alcohol, food, and
stress.
Any suggestions?"
Firstly M, we think you should do whatever you can to seek medical
assistance as soon as humanly possible. Is it possible for you to see
your general practitioner prior to going to the ER? Limiting food
intake is the usual initial treatment but as you allude - it can be
difficult and you also want to ensure nutrition (and most importantly
ensure that you are keeping well hydrated). You should attempt to keep
water intake. Yoghurt might not be the best thing due to the fat
content. Definitely low fat variety and even then probably only small
amounts. Try a small amount and see how it goes. Also, some mashed
potatoes, pumpkin/other vegetables might be worth a go. As you'll see
in the interview with dietitian, sometimes some hospital grade sustagen
or similar product could be helpful.
Please try to obtain some medical assistance and let us know how you
get on!
All the best
Jenny
Does taking enzymes reduce your pancreas' ability to produce its
By sankey on Sunday, May 30th, 2010 | No Comments
Hi everyone
JS responded to one of our newsletter articles (written by our good
friend June Henry) in relation to the effect of enzymes on pancreatic
function. Specifically, JS asks for any evidence of this.
Essentially, June was writing from personal experience and the common
practice observed from medical practitioners. June mentioned the
following relating to this issue:
In this case, taking enzymes can be temporary, however it
> is not unusual for a person who has a functional, but permanently
> damaged pancreas to take enzymes for the rest of his life too. But
> my impression is that the need arises from the damage that was done
> prior to the start of enzyme therapy, not as a result of any long
> term suppression caused by the supplementation itself. (Of course,
> as the reader pointed out, supplements can also decrease symptoms
> of maldigestion in this sub-type of pancreatitis).
>
> So the answer to his question is that yes, supplemental enzymes are
> thought to decrease the amount of enzymes that a pancreas will
> produce and secrete. However, I do not know if this is a long
> lasting effect; my impression is that it suppresses the production
> and release of natural enzymes only for as long as they sit in the
> gut. I do not know of any cumulative or long term suppression in
> relation to pancreatic enzymes but it sounds possible based on
> other drug / body interactions (many medications require tapering
> rather that quitting cold turkey).
>
> In the situation described by the reader, his/her discomfort after
> discontinuing the enzyme supplementation could be caused by many
> things. But I am speculating that the pancreas may not be able to
> make adequate amounts of enzymes any more based more on the disease
> itself rather than as a result of taking supplements.
JS responded with the following:
Below you have written an excellent summary on details of a complex
question "do supplemental enzymes decrease the amount of enzymes that a
pancreas will produce or secrete?"
You said "yes" in your answer below. Is this based on a study? What
evidence have you read or located to support such a statement? Please
email me back any information you can.
I have asked one gastroenterologist about this. He disagrees but has
no data to support his statement either. I am checking with the chief
gastro-surgeon at Moffitt but getting an answer back will take time
because those folks stay busy.
I have had a Whipple, and these enzyme pills seem to help digestion.
My gastro-doc has doubled the pills when I got pancreatitis shown by
CT. The tradtional pain lasted for 4-5 days. There has been no more
attacks since
the double dossage. However, if these pills are weakening, what
remaining
pancreas I have to produce these enzymes, doubling enzymes doesn't seem
like such a good idea.
You can see why my request for a reference to support your statement
would be extremely helpful.
If anyone has any comments please let us know. I'm sure there will be
more discussion on this issue as time goes on.
All the best
Jenny and Bill
Another reader's story - pancreatitis pain
By sankey on Monday, April 12th, 2010 | 16 Comments
Hi everyone. A reader, CB wrote to us recently and asked us to post
her story:
"I have been suffering with pain since Thanksgiving 2009. Actually
about a month or two before but not as severe until Thanksgiving. I am
not an alcoholic and rarely drink. On Thanksgiving I was admitted into
our local hospital. I was put on an IV and pain killers. I was told
that I had gallstones. Two days later they removed my gallbladder and
appendix and fixed a small hernia. I continued to have pain on my left
side right below my ribs which radiated to my back. I continued to go
to my family doctor and advised her of this. She stated that it would
take time to recover from this surgery. I continued to have pain and
she took a blood test which showed my white blood cells were elevated,
so assumed that the pain was due to an infection. I was treated with
antibiotics and told that there was a pocket of fluid by the incision
from the hernia surgery. When the pocket of fluid wasn't reduced after
the antibiotic treatment, the doctor tried to drain the pocket by
reopening my belly button. Even after that I continued to have pain.
Finally after almost 2 months after my surgery, I was sent to a
gastrinologist. At first all he did was give me more pain killers and
review blood tests. He advised me that my pancreas and liver levels
were high. Which for my pancreas was told they should be between 0 -
300 and were coming back at the lowest 900. I was then told to go on a
low fat diet. So I did, but I was still having pain. I eventually
went on a completely fat free diet. I still continued to have pain.
Another visit and the doctor finally decided to schedule some tests.
The first test was an MR/CP. The radiologist said that it showed
nothing. Thank God the doctor decided to review the scan himself. He
advised that he seen a small blockage in the tail end of my Pancreas.
He then scheduled me an ER/CP.
After that test he verified that there was a blockage. I was then
referred to a University for an EUS. At that time a biopsy was taken.
I was informed that the test results came back inconclusive. I was
then referred to a surgeon. On March 8th 2010 I went in for surgery.
The surgeon was almost positive that I had cancer. 75% of my pancreas,
my spleen, 22 lymph nodes, a stomach biopsy and a wedge resection of my
bowel was performed.
(It turned out to be a cyst in my pancreas which was not cancerous) I
was in the hospital for 6 days. My recovery started out good. I had a
JP tube in to get the excess fluids out of me. After approximately 2
weeks the JP tube was removed. On that day, I went to our local ER in
so much pain, I could barely breathe or move. They sent me back to the
University Hospital who performed the procedure. They ran several
tests and came up with no cause.
I was kept in the hospital for 2 days and when released was advised
that I needed to go back on a fat free diet. The day after being
released I went back to the gastronologist for his opinion and
assistance. At that time he referred me back to the University ER. It
has been 8 days now with only minor pain. Today however the pain was
back. The only time I have had complete relief is when I have been on
a complete liquid diet. I know this is not healthy by any means. I
have lost almost 40lbs since the procedure that was done on March 8th.
I am absolutely terrified that I will die as the doctors seem not to be
able to do anything except give me pain medication, which is beginning
not to work anymore. I need help and feel I have nowhere to turn.
Every doctor I see continues to refer me back to the Hospital that
performed the procedure. Even my insurance company which assigned me a
case manager is concerned. I have two children and am so worried. I'm
afraid to sleep or eat anymore. I don't know what to do or where to
turn."
As a postscript to CB's original note:
"I have an appointment on April 15th with the surgeon and will press
her for answers as to the diagnosis of my condition and what avenue I
should take to finally be done with this extreme pain. I will advise
you of what I find out. Hopefully my information and story will help
someone out that is experiancing the same issues. Thank you for your
research and your support. As bad as this may sound, it's nice to know
I'm not alone in my suffering."
We'd love to hear from any others who have had similar experiences to
CB (and I'm sure CB would love to hear from you as well!).
I'm sure all of us wish CB all the very best.
Kind regards
Jenny
When is surgery (or even a total pancreatectomy) the answer?
By sankey on Monday, March 29th, 2010 | 2 Comments
Hi
BP from Sacramento California asks this question in a recent email -
something many who have had pancreatitis as long as he has often ask
themselves. If you have any thoughts on this please leave a post.
In the meantime, thanks to BP for sharing your thoughts and concerns.
Regards and best of health to all
Jenny
FROM BP:
I have had idiopathic chronic pancreatitis for more than twenty years
and for twenty years prior I had occasional attacks of sharp pain that
had been variously misdiagnosed, but was likely my pancreas. Three
months ago I had an attack which generated not only pain under the
sternum, but also on the back right side of my rib cage which has never
resolved. I was unable to return to eating anything without taking
enzymes. It seems the pain on my rib cage is gradually increasing and
often after eating even a nearly fat free meal with small portions I
have pain on the front of the chest which will usually resolve by
taking another enzyme capsule.
I had an MRI/MRCP dye contrast which shows a badly atrophied body and
tail of the pancreas and two pseudo cysts (fluid)approximately 3/4 inch
diameter and about 1 and 1/4 inch long. They both touch the duct which
appears totally normal. I had the gall bladder removed 2 1/2 years ago
because I was passing stones. My pancreas is apparently not producing
much of anything to assist in digestion and is only giving me pain.
I am 66 years old, am not diabetic yet, have aggressive coronary artery
disease, but at the moment no angina and take no medications for the
heart.
I have investigated the possibility of a total pancreatectomy with
islet cell transplant in the liver at the University of Cincinnati
Pancreas Disease Center. I am not sure I can get medicare or insurance
to approve the procedure, but it looks like a possible way out of my
pain without becoming diabetic.
What are the negative consequences of such a surgery? Is it a possible
solution to remedy the pain? Another pancreas sufferer said that she
was told a total pancreatectomy would result in phantom pancreas pain.
Is that true? Thanks for taking my questions.
Keep asking questions!
By sankey on Monday, March 1st, 2010 | 6 Comments
As most would know we strongly advocate asking questions of medical
professionals if you are ever in doubt or unsure about the diagnosis
process, what treatments are being considered for pancreatitis, etc.
We've had some recent feedback from LM who writes about recent
experiences with her 13 year old daughter who has just had a
first attack. We'll let LM tell the story:
Hi i am so sorry your dad wasnt diagnosed properly you must be
devastated and let down by the health profession.
My daughter who is only 13 had her first pancreatitis attack in
September followed by being diagnosed with ulcerative colitis and is
now on drugs to control colitis which can bring back pancreatitis! She
has now had a second pancreatitis attack and the hospital she is under
thought it was her just not "managing the pain" but we stuck together
as a family and said it wasnt acceptable her pain and after 10 days
they are now listening to us and her after implying "difficult family
circumstances" is the problem! She had an ultrasound yesterday and is
having an MRCP scan next week now and may go on pancreatic enzymes like
you mentioned. Fingers crossed the health care havent messed up and let
her pancreas get too bad as she is on tramadol for pain as i insisted
and anti sickness drugs. Its been a trying time for the last 6 months
in and out of hospitals with 2 recurring diseases running alongise so i
know how you must of felt.
Reading your article has armed me with fresh ammunition to ask more
questions for a meeting in 1 hours time with the consultant so thank
you for that.
Take care
LM
Holistic Help
By sankey on Sunday, February 28th, 2010 | 2 Comments
Recently received an email from a sufferer who has found the assistance
of a doctor specializing in holistic medicine to be helpful. Thought
readers may find this of interest.
All the best
Jenny and Bill
Thank you for your information. It helps tremendously. I wanted you to
know since I've been seeing a Holistic Dr I haven't been in the
hospital. I was in and out with severe symptoms requiring 4-5 day stay
with 25 mil phenegrin and 50 mil fentaynol every 4 hours til i was
better. Enough to knock out an elephant. This went on for several years
with a diagnosis of `virus' and gastritis. Finally i saw a different Dr
that diagnosed me with chronic pancreatitis. Back to back episodes in
the hospital forced me to look for more information. This Dr is
treating me with herbs and a drastic food change with eating food
combinations. No hospital since July 09 and counting. I would like to
recommend this treatment is effective.
Deciding on surgery
By sankey on Sunday, February 7th, 2010 | 5 Comments
Hi everyone
KM recently wrote to us to explain that her husband is being considered
for surgery on a small pre cancerous cyst on the tip of his pancreas.
KM is worried about this - her husband is 73 and she's not sure it
(surgery) is the best options. If the cyst is pre-cancerous, then
maybe it is best left alone. KM has asked if anyone else has had
similar experiences and if so, would they mind posting them - it might
be very helpful to her in making a final decision whether or not to
proceed with surgery.
Regards
Jenny
It's Tough Getting Fair Treatment
By sankey on Monday, April 6th, 2009 | 43 Comments
Just received a request for assistance from a reader who is not
receiving the best treatment from their doctor/s. This response (see
below) to an earlier post is so typical of the plight of so many with
pancreatitis, isn't it! We've written about this situation before -
will make sure these articles are included in this blog. In the
meantime, if anyone would like to comment and offer some further advice
please leave a comment.
All the best everyone.
Bill
"A month ago I was hospitalized for two weeks with severe pancreatitis
and gallbladder stones. After two weeks of no eating or drinking I
finally was sent to surgery and my gallbladder and lap-band (of 5
years) was removed.
Two days after returning home from the hospital severe abdominal pains
started, mostly down in my right pelvis area. I have been to the ER 3
times since coming home and have been diagnosed with diverticulitis
(and undiagnosed), degenerative disc disease and high lipase levels
that after one night in the hospital lowered to high-end normal.
My question is this: Are there any of you out there that suffer with
this disease, only have pain in the abdominal/pancreas area or do you
sometimes have it all over? My pain at first felt like a hot poker was
being stabbed in my left hip. Then last week the pain has shifted to my
right lower abdomen. This week I feel like I have been punched with an
upper-cut by a world prized fighter right under my rib cage. I have
been sent home with Lortab which does little- to- nothing for the pain
and I have been put on steroids being told that my degenerative discs
were causing the abdominal pain. The prednisone course is done and I am
still in pain. I'm to the point that I feel as if I am going to have to
self treat this because my doctors here in my small community write me
off as being nothing but a hypochondriac. I've had one Dr. tell me it
will take months to get over, while another doctor the same day tell me
it's not my pancreas because I only had an attack because of my
gallstones, and not one health professional has given me any feed back
as to what to eat, how to live, or information on what this disease is.
I feel as if I am going crazy!
I just feel like I am going out of my mind. Any stories of your pain
symptoms would be greatly appreciated!! I have purchased each of the
three books and am on my way to living with this but trying to make
intelligent decisions in my care and see if I really am going crazy or
not."
Taming the Sugar Beast (Part IV) - Do you go organic?
By sankey on Saturday, March 28th, 2009 | No Comments
Interesting to hear of a recent report in Diabetes Care that found a
strong relationship between Type II diabetes and pollutants in the
body. Some may now argue that because of the use of contaminants in
conventional commercial vegetable and fruit growing operations, that
people with diminished pancreatic function should stick to organically
grown food.
I've got to admit I haven't been able to find a copy of the actual
study but the article I read mentioned six particular pollutants as
being of concern, including:
* hexachlorobiphenyl
* 2 dioxins: heptadioxin and OCDdioxin
* 2 pesticides: oxychlordane and trans-nonachlor, and
* a pesticide metabolite: DDE, a metabolite of DDT
It seems the study found that these chemicals were found in more than
80 percent of the study participants and this group had almost 38 times
greater likelihood of developing diabetes as those with the lowest
level of exposure.
As we say in the book `Cooking Hints and Recipes for Pancreatitis' one
shouldn't want any chemical additives to the food one eats. Our
preference would be to go organic, but we realize that's not always
possible for everyone because of price, availability and assurance that
you are in fact getting organic. (One thing you find when you start
looking in to this area of food processing is that there is a `range'
in determining whether or not something is organic).
Nevertheless, the evidence seems to be mounting that chemicals used in
the growing of food can and do have an impact upon the ultimate
consumer of that produce. I can't vouch for this, but the article I
read said that the average American takes in nearly a gallon of
pesticides per year by eating conventionally grown fruits and
vegetables! For the pancreatitis sufferer, it means continued vigilance
in controlling what food one consumes, not only because of the
potential poisoning but also because of the greater risk of further
impairment to the pancreas and the potential for increasing the
potential on-set of diabetes.
Until next time.
Bill
info@pancreatitis-advice
pancreatitis-diet
Taming the Sugar Beast (Part 3)
By sankey on Sunday, February 1st, 2009 | 3 Comments
White is NOT right when it comes to sugar (..and rice...and bread!)
We've probably all suspected it for a long, long time but there's now
growing empirical evidence that in the pursuit of perfect-looking white
sugar and fluffy white bread rolls and rice, we've emptied these
products of their original nutritional value and have, in the process,
increased our risk of disease. Richard Weisinger of La Trobe University
in Melbourne Australia has recently reported finding important
nutritional health benefits in products that are removed when
processing white sugar.
"When sugar is processed, the stuff that is thrown away seems to have a
lot of polyphenols" he explained recently.
Polyphenols are natural plant chemicals that have powerful antioxidant
properties and numerous potential health benefits. One of these
potential benefits, suggests Weisinger, is to reduce the amount of fat
our body retains after eating a fatty meal. Returning polyphenols to
our refined sugar has the potential to reduce insulin resistance and
diabetes.
In the experiments Weisinger used mice to test the benefits of
polyphenols in sugar. He found that polyphenols reduced the amount of
fat that mice stored in their bodies. The mice given the polyphenols
did not get as fat as the ones without the polyphenols.
Weisinger explained that these benefits are specific to polyphenols
from sugar cane which are different from those found in other food
sources such as green tea. He hopes his research can be used to benefit
individuals at risk of diabetes by reducing insulin resistance. Insulin
is produced in the body (as we know by the pancreas). It removes sugar
from the bloodstream and stores excess sugar as saturated fat. Insulin
resistance, the cause of diabetes, leads to an inability to remove
sugar from the blood.
Researchers are unsure precisely how polyphenols act in the body to
reduce fat intake, but Weisinger has some ideas:
"Polyphenols increase energy excretion and make it more difficult to
store fat, For example, instead of your body absorbing all of the
calories from a meal, it will only keep 90% of the calories. The
remaining calories are excreted in faeces."
Weisinger goes on to explain that larger fat cells, that store a lot of
fat, release certain hormones that are inflammatory - certainly not
something that pancreatitis sufferers need! Any inflammatory inducing
hormones could cause inflammation of the pancreas and cause a flare-up.
So, what's the upshot of this research for the pancreatitis sufferer.
Well, firstly as we've been reinforcing throughout previous articles,
it is best to remove the need for additional sugar in the diet. Any
additional blood sugar is going to put pressure on the pancreas to
produce the insulin required to remove the sugar from the bloodstream.
Everyone's tolerance of sugar will be different, but if you are
currently adding sugar-based products to your cooking or tea and
coffee, then it will be best to use sugar cane products with the least
level of processing. From the article I read about Weisinger's research
it wasn't clear what alternatives to white cane sugar there might be.
One could presume that raw can sugar would contain a higher number of
polyphenols than the white.
There's obviously a lot more research that needs to be done in this
area, but I still tend to think that the pancreatitis sufferer will do
well to continue to reduce his/her `sweetness habit' and in the process
use natural sweetners such as stevia.
Oh, some may have been wondering why we ever started removing the
polyphenols from sugar cane. As Weisinger explains, "Polyphenols are
bitter. People like white, beautiful and very sweet sugar". Just
reinforces our belief that we've become increasingly addicted to
sweetness in our food and we must start to tame the sugar beast before
it gets completely out of control! Colour in our food is a very good
thing.
Till next time.
Bill
info@pancreatitis-advice
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+ Does taking enzymes reduce your pancreas' ability to produce
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+ Another reader's story - pancreatitis pain
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