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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.com

www.pancreatitis-diet.com

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.com

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