Dietary Advice for Acute Pancreatitis

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What is the pancreas?

The pancreas is a gland that is located behind the stomach. It has two main functions:

1. It produces enzymes, which help to break down and digest the food we eat.
2. It produces hormones, including insulin, which enables our body to use the glucose (sugar) that is produced from the digestion of certain foods.

What is acute pancreatitis?
Acute pancreatitis occurs when the pancreas suddenly becomes inflamed. Symptoms include:

• Feeling or being sick (vomiting)
• A high fever (more than 38 degrees centigrade)
• Abdominal pain
• Diarrhoea

There are several causes for acute pancreatitis, but the most common ones are:

• Gallstones: which can temporarily ‘block’ the pancreas.
• Excess alcohol can damage the pancreas. Avoidance of alcohol in the future is recommended in this case.

Eating and drinking with a flare up of acute pancreatitis:
If you have mild to moderate acute pancreatitis you may be asked to avoid eating or drinking for up to 5 days. Then, once your symptoms have improved you will be allowed to gradually start eating and drinking again. If your doctors have advised you to be ‘Nil by Mouth’ for longer than this your dietitian may recommend alternative feeding methods. When you initially start eating and drinking again it is suggested that you follow a lower fat diet as this may cause fewer troublesome symptoms. Base your meals around starchy carbohydrates such as bread, cereals, potatoes, rice, pasta and include protein foods with each meal such as lean meat, fish, eggs, yogurts.

Below is a table showing some lower fat food options to choose when you initially start eating again. If you require support when looking at the hospital menu, please speak with a nurse or ward dietitian. Usually within a week, depending on your symptoms, you can return to having your normal diet. However, if you are discharged and still experience symptoms there are some strategies you can use to limit the fat content of your diet on the next page.

What to do if you are prescribed pancreatic enzyme replacements
If you are prescribed a pancreatic enzyme replacement therapy e.g. Creon®, Nutrizyme®, Pancrex® Or Pancrease® this should be taken with ALL meals, snacks and nutritional supplements. Your ward dietitian will be able to give you more specific advice about this. Your doctors should explain how long these are required for.

Useful tips for reducing the fat in your diet at home are:
• Avoid processed and convenience foods and takeaways. Try to make more meals from scratch.
• Look at food labels and choose foods that contain less than 3g of fat per 100g. Avoid foods with a red traffic light colour indicating the food is high in fat.
• Remove all visible fat from meat and skins from poultry BEFORE cooking.
• Use healthier cooking methods such as grilling, boiling, steaming and poaching rather than roasting or frying.
• If frying foods try to use minimal oil. You could try a spray oil to minimise fats used in cooking.

After an attack of acute pancreatitis you may have unintentionally lost weight and/or your appetite may remain poor. If this is the case then:

• Have snacks in between meals.
• Try to have a snack or meal every 2-3 hours during the day.
• Include a pudding or dessert after lunch and supper.
• Include nutritious milky drinks or fortified soups, e.g. Meritene® or Complan® which can be purchased at supermarkets or chemists.

Here are some ideas for suitable low fat, high energy/protein snacks:
• Try jelly as a dessert.
• Toasted tea-cake, toast or crumpet with jam, marmalade, honey or lemon curd, no butter/spread.
• Meringue nests with fruit.
• Plain biscuits such as ginger snaps, Rich Tea®.
• Add sugar to drinks.
• Tinned fruit in syrup.
• Reduced fat yoghurt.

If your food intake has not improved or if you are losing weight unintentionally, contact your GP, nurse or dietitian.

Lower fat food options to choose during or after a flare up