Keys to a Pancreatic Insufficiency Diet

Your diet may not look like your friend’s, and it likely won’t resemble the latest health craze on Instagram. Instead, you should eat a nutritious diet tailored to your specific needs, says Christine Gerbstadt, MD, RD, a former spokeswoman for the Academy of Nutrition and Dietetics and author of Doctor’s Detox Diet: The Ultimate Weight Loss Prescription. In fact, your diet may even be different from those of other people with EPI, depending on what’s causing your condition and whether you’re malnourished. These five strategies can help ease EPI symptoms for many people. Just be sure to talk to your doctor before making any changes to your diet.

  1. Get plenty of fluids. It’s important to stay hydrated throughout the day, Dr. Gerbstadt says. She explains that dehydrationputs severe stress on the body and can contribute to symptoms of EPI. “Hydration is best for prevention and treatment and is usually considered the first step before all others,” she says. An easy rule to remember is to drink eight 8-ounce glasses of fluids a day, which can include water, tea, coffee, and even soup broth. Check with your doctor for more details.
  2. Eat small, healthy meals more often. For people with EPI, a healthy diet usually includes moderate amounts of healthy fats, which can be found in foods such as avocados, salmon, and nuts. In the past, it was believed that people with EPI should avoid eating fat, but that’s no longer the case. As long as you’re taking the right dose of pancreatic enzyme replacement therapy (PERT) with your meals, you shouldn’t be experiencing EPI symptoms such as steatorrhea (greasy, foul-smelling stools) and abdominal pain, according to StatPearls. To help ease digestive pain, try eating smaller, more frequent “mini meals” throughout the day instead of a few large meals, Gerbstadt adds. If you need help shoring up your diet, ask your doctor for a referral to a dietitian.
  3. Use dietary supplements. You probably already know that “replacing lost pancreatic enzymeswith oral supplements can ease pain and cut down on loose stools early in the course of [EPI],” says James Farrell, MD, director of the Yale Medicine Pancreatic Diseases Program in New Haven, Connecticut. (This is especially the case for those who have cystic fibrosis, because thick mucus blocks their digestive enzymes from leaving the pancreas.) But because people with EPI are often deficient in fat-soluble vitamins A, D, E, and K, according to research published in September 2018 in the journal Pancreas, your doctor may also suggest taking additional supplements. Selenium and antioxidants like vitamin C, for example, could help decrease inflammation, according to the Linus Pauling Institute at Oregon State University.
  4. Avoid a high-fiber diet. The digestive and heart benefits of a high-fiber diet have been touted for years, but for those who need to follow an EPI diet, cutting back on fiber may actually be the better choice, according to StatPearls. Research has shown that high-fiber foods can increase the amount of fat a person with EPI loses in their stools and raise the risk of malnutrition. Gerbstadt says fiber doesn’t cause problems for everyone with EPI, so talk to your doctor about whether you need to limit it or not. If a low-fiber diet is appropriate for you, it’s still important to eat fruits and vegetables. Ask your doctor or a registered dietitian about the best fresh produce to choose. Generally, tender cooked vegetables, such as carrots, beets, and spinach, are lower in fiber than foods like berries and raw vegetables.
  5. Stop drinking alcohol (and quit smoking, too). EPI frequently occurs in people with chronic pancreatitis, a condition that’s often the result of heavy, long-term alcohol use, according to a review published in October 2019 in Minerva Medica. “Decreasing or eliminating alcohol entirely may reduce inflammation of the pancreas,” Dr. Farrell says. Drinking puts your pancreas at risk for even more irreversible damage. You could also develop diabetes if the cells that produce insulin in the pancreas are damaged. If you need help quitting alcohol, there are many support groups and strategies, including Rethinking Drinking, sponsored by the National Institute on Alcohol Abuse and Alcoholism. Even if you’ve never been a heavy drinker, it’s probably best to limit or abstain from alcohol to help ease the discomfort of EPI. And while you’re abstaining from alcohol, kick your cigarette habit to the curb if you smoke. Along with countless benefits to your lungs, heart, and overall health, quitting smoking can also improve the health of your pancreas. According to a meta review published in December 2019 in the journal Pancreatology, smoking increases the risk of acute and chronic pancreatitis, and that the risk goes up with the amount of cigarettes and length of time a person smokes. “Smoking is a risk factor for the development of pancreatic cancer, which can occur after chronic pancreatitis,” Farrell says. Cigarette smoking is the leading preventable cause of pancreatic cancer, according to Johns Hopkins Medicine Pathology. Dietary and lifestyle changes can improve the symptoms of EPI. Talk to your doctor or dietitian about additional diet strategies that may be appropriate for you.