The Pancreas is an organ that sits behind the stomach and plays an important role in digesting food and regulating blood sugar.
Pancreatitis is a serious problem that can disrupt the normal function of the pancreas and may require changes to the way you eat.
This article will provide an overview of pancreatitis and how to manage this condition from a nutrition point of view.
What is Pancreatitis?
Pancreatitis is an inflammation of the pancreas, and it occurs when the pancreas attacks itself with the same digestive enzymes that are normally used to break down food.
Pancreatitis comes in two main types: acute and chronic. For those at risk of pancreatitis, A doctor may use a special test known as an endoscopic retrograde cholangiopancreatography (ERCP) to diagnosis the exact issues.
Acute pancreatitis: Pancreatitis that appears suddenly is known as acute pancreatitis. Symptoms include:
- severe abdominal pain
- rapid heart rate
Acute pancreatitis usually resolves quickly with proper treatment, which may include hospitalization for IV fluids, medication to manage pain, and giving your stomach a rest. In some cases, acute pancreatitis can be life-threatening, and any symptoms should be taken seriously.
Chronic pancreatitis: When the pancreas is permanently damaged from inflammation, the condition becomes long-lasting, as is known as chronic pancreatitis. Chronic pancreatitis usually develops slowly over time and can diminish your ability to digest food (this is known as the pancreatic exocrine deficiency). Symptoms people with pancreatitis may experience include:
- fatty stools
- abdominal pain – especially with fatty foods
- unintentional weight loss
- formation of a painful cyst known as a pancreatic pseudocyst.
There is no cure for chronic pancreatitis, but the condition can be managed, and the damage can be slowed. Treatment usually involves the correct diet, taking pancreatic enzymes, and managing symptoms.
Causes of pancreatitis
The most common cause of pancreatitis is gallstones. Gallstones are an abnormal buildup of bile, a substance that is stored in the gallbladder.
Sometimes, these gallstones can block the pancreas from releasing digestive enzymes. These blocked enzymes then start to eat and damage the pancreas itself, a process called autodigestion.
The next most common cause is excessive alcohol consumption. Alcohol is partially metabolized in the pancreas and produces byproducts that are toxic in large quantities.
Researchers are still working to understand exactly why some people with alcoholism get pancreatitis while most do not.
Other causes of pancreatitis include:
- Genetic factors
- Certain medications
- Abdominal trauma
- Cystic fibrosis
Is pancreatitis connected to diabetes?
Since one of the main functions of the pancreas is to produce insulin, damage to the pancreas can cause diabetes. This occurs when the inflammation spreads to the insulin-producing cells of the pancreas. With these cells destroyed, the body is unable to regulate blood sugar and may require insulin medication.
In people already with diabetes, pancreatitis can also worsen blood sugar control for the same reasons discussed above. A person with well-controlled diabetes who goes on to develop pancreatitis may find it harder to maintain normal blood sugar levels.
How can foods affect your pancreas?
To break down the foods you eat, your pancreas secretes three different kinds of digestive enzymes: protease, amylin, and lipase, which break down proteins, sugars, and fats, respectively.
Thus, eating a heavy meal such as a greasy pizza will activate the pancreas to release a large number of enzymes to fully break down the food.
The pizza will also contain many carbohydrates, which will require the pancreas to release insulin to regulate the blood sugar response to the meal.
Nutrition treatment for pancreatitis
Because the pancreas is very involved with handling meals, nutrition plays an important role in the treatment of pancreatitis.
For acute pancreatitis, the focus is on giving the pancreas time to rest. This may involve a period of fasting with nothing but fluids for a little while.
As symptoms improve, you may progress to a diet that is low in fat and concentrated sugars to reduce the burden on the pancreas. Since acute pancreatitis lasts only a short while, this may be all that is required to manage the condition.
In those that are at risk for malnutrition, tube feeding is sometimes used to supply carefully tailored nutrition without harming the pancreas.
In rare cases, when all forms of food are not tolerated for an extended period, intravenous nutrition (known as parenteral nutrition) is needed.
Nutrition is a significant part of the lifestyle of people with chronic pancreatitis. Since the damage done in chronic pancreatitis cannot be reversed, eating right can help to slow down the damage and keep the pancreas working as well as possible.
There are several priorities for nutrition management in chronic pancreatitis:
- Preventing malnutrition. The risk of nutrient deficiencies is high due to reduced absorption from food, lower appetite, pain with eating, and increased energy needs from inflammation.
- Reducing strain on the pancreas. The pancreas will work harder and produce more digestive enzymes in heavy meals, especially those high in fats and sugars. Keeping these nutrients in moderation (but not eliminating them) is important to reduce pancreatic inflammation. If pancreatic enzymes are needed, these should be taken will all meals and snacks to assist the pancreas with digestion.
- Controlling blood sugar. Remember that a damaged pancreas may not be able to keep up with the blood sugar demands of the body. To help it out, making certain diet changes, especially with portion control and carbohydrate moderation, can help keep sugars in check.
- Avoiding alcohol. Alcohol abuse can cause immediate discomfort in pancreatitis and will further exacerbate the condition. It is best to avoid alcohol entirely with pancreatitis.
With these priorities in mind, what does a pancreatitis diet actually look like?
What is the best diet for pancreatitis?
A pancreatitis diet includes the following components:
- Small, frequent meals. Spreading out meals into smaller chunks is usually better tolerated as they are easier for the pancreas to handle. Eating frequently also helps to prevent malnutrition. Aim for about 6 meals per day.
- Moderate to low fat. You will want to keep total fat to about 30% of total calories. This includes all types of fat, even healthier fats such as olive oil. It may be a good idea to log all meals for a few days into a nutrition analyzing software such as the USDA nutrient database to get a feel for how much total fat you usually eat.
- Consider MCT oil. MCT stands for medium-chain triglycerides, which is a type of fat that does not require pancreatic enzymes to be absorbed. Some evidence suggests that these oils can be better tolerated, and can improve diarrhea associated with pancreatitis. MCT can be taken in supplement form.
- High-quality lean protein. Protein is important for healing and maintaining strength. Since many protein sources also contain fat, it is essential to prioritize lean protein choices such as turkey, fish, chicken, or plant sources.
- Plenty of fruits and vegetables. Try to make half of your plate fruits and vegetables. This will ensure that vitamin and mineral needs are being met. They also contain antioxidants, phytochemicals, and other beneficial compounds to fight inflammation. Fruits and vegetables also contain fiber, which will help keep to control spikes in blood sugar.
- Less Processed foods. Processed foods are generally low in fiber, high in sugars, fat, and sodium and of poor nutrient quality. Choosing whole, unprocessed foods, whenever possible, is a key part of the pancreatitis diet.
- Choose the right types and amounts of Carbohydrates. Carbohydrates (sugars and starches) are an essential energy source, and they generally should make up about 50% of the total calories. However, not all carbohydrates are created equal. Whole grains are preferred to their higher fiber and nutrient content.
- Avoid too much-added sugar. Added sugars are sugars not naturally present in a food item; they can make it very easy to have too much sugar without realizing it. Added sugars are found in sodas, sports drinks, juices, candy, pastries, and many other foods. Check the nutrition facts label for the most accurate information.
- Adequate fluids. Staying hydrated is a commonly overlooked aspect of nutrition, but it is no less important. About 8-10 cups of fluid per day are recommended. If you have trouble getting enough fluid, consider keeping a refillable water bottle with you as a reminder.
What are the foods to include in a pancreatitis diet?
The following are examples of foods for pancreatitis:
Fruits and vegetables:
- Green Beans
Most fruits and vegetables can be included in a pancreatitis diet plan and will be well tolerated. An exception is a grapefruit, which can interact with many medications. Ask your doctor about grapefruit if you eat it regularly.
- Sweet Potato
- Brown rice
- Whole wheat bread
- Whole wheat pasta
- Black beans
- Skinless chicken breast
- Skinless turkey breast
- Egg whites
- Whole egg (1-2 per day)
- Protein powder
Fats (limit overall fat):
- Olive oil
- Oil sprays
- MCT oil
- low-fat cottage cheese
- Skim or 1% milk
- Sugar-free seltzer water
What are the foods to avoid in a pancreatitis diet?
Keep the following foods limited as much as possible. Keep in mind that this list is not comprehensive, and you should use the above priorities to guide your eating choices.
- Processed meats such as salami, pepperoni, and roast beef.
- High-fat red meats such as ribeye steak and burgers.
- Fried foods, including french fries.
- Processed, high-fat cheeses such as American and cheddar.
- Cream soups
- Whole milk
- Sports drinks
- Sugary cereal
Sample menu for a Pancreatitis diet
- Egg omelet with 1-2 eggs, chopped bell pepper, and onion
- One slice whole-wheat toast
- 8oz skim milk
- 6oz low-fat yogurt
- Tuna sandwich with whole wheat bread, tomato, lettuce
- Baby carrots with hummus
- ½ cup of raspberries
- 8oz skim milk
- Mozzarella cheese stick
- 15 grapes
- Baked buffalo chicken
- Salad with spinach, lettuce, tomatoes, and low-fat dressing
- ½ cup of black beans
- ½ cup of brown rice
- Orange slices
Diet tips for diabetes
- Portion control is important. Follow the healthy plate method of 1/4th starches, 1/4th protein, and half non-starchy vegetables.
- Limit sugar-sweetened beverages. It is best to only drink beverages with zero grams of sugar, except for low-fat milk.
- Understand carbohydrates. Carbohydrates (sugars and starches) are the primary nutrient that affects blood glucose. Carbs do not need to be eliminated, but simple eaten in controlled quantities. For those counting, carbohydrates aim for 45g per meal.
- Weight loss. If you have weight to lose, losing just 5% will significantly improve blood sugars.
- Make it a Lifestyle change. With any diet, make sure to start small and make one realistic change at a time.
Pancreatitis is an inflammation of the pancreas and can be both acute or chronic. When the pancreas is inflamed, the main functions of digesting food and producing insulin can be impaired.
To manage pancreatitis, a special diet should be followed. A pancreatitis diet generally includes plenty of fruits and vegetables, whole grains, and lean proteins.
Foods high in fat and sugar should be kept to a minimum. Medications such as pancreatic enzymes and supplements such as MCT oil are sometimes used to assist with symptoms.
Following the pancreatitis diet will help prevent further damage to the pancreas, manage symptoms, and avoid malnutrition.