GIST Support Wiki

Post Whipple Diet

Here is a link to a fulltext article on nutrition after Whipple surgery. Dr. Espat, one of the authors, is both an hepatobiliary surgeon AND a nutritionist!

Eat as if you had gastric bypass light and go from there....

Nutrition Following a Whipple Procedure;

Patients who undergo the Whipple procedure often have many questions and concerns regarding post-operative nutritional care. First and foremost, patients and their caregivers should understand that each patient has individualized nutritional needs. All patients should consult with a registered dietitian or doctor prior to making any changes to the diet and to create an appropriate dietary plan.

Typically, after a Whipple procedure the patient's diet should not include large meals or fatty foods. A low fat diet of 40-60 grams of fat per day may be necessary on a long-term basis. In addition, drinking a small amount of fluids with meals may help prevent bloating, high gas production, abdominal cramping, and diarrhea.

These are a few diet recommendations following a Whipple procedure:

A jejunostomy tube (j-tube), or a feeding tube, may be temporarily inserted into the digestive tract during surgery to help maintain and restore an optimal nutrition.

Gradually work back to an oral diet of solid foods. The timing of this varies from individual to individual.

Avoid high-fat, greasy or fried foods.

Increase the intake of nutrient-rich foods.

Eat 5-6 small meals daily to prevent feeling overly full. Small meals are easier to digest. Consider spacing meals 2-3 hours apart.

Drink at least eight cups of fluids each day. Lack of fluids may lead to fatigue, lightheadedness, and nausea. Drink liquids an hour before or after eating to avoid the feeling of fullness.

Take small sips of liquids with meals. Excess fluids at mealtime may limit food intake because patients may feel full quicker or may have increased nausea. Large amounts of liquid leave little room for solid foods that are rich in calories and nutrients.

Drink beverages that contain calories and nutrients. It is acceptable to drink these at mealtimes.

Avoid alcoholic beverages.

During periods of nausea, dry foods are often better tolerated than liquids.

Avoid high intake of concentrated simple sugars if symptoms such as high thirst, frequent urination, fatigue, flushed skin, dizziness or light headedness, weakness, abdominal pain, nausea, vomiting, or diarrhea are present.

Consider taking a multi-vitamin or individual vitamin supplements. Calcium and the fat-soluble vitamins A, D, E, and K may be necessary if fat malabsorption-induced diarrhea is present. Ask a healthcare professional for a proper dosage of individual vitamin supplements.

Ask the patient's physician about supplemental injections of vitamin B12 to avoid anemia.

Take the prescribed amount of any pancreatic enzyme replacement medication with all meals and snacks. After surgery, the remaining portion of the pancreas may produce little or no enzymes to digest carbohydrates, proteins, and fats.

Consider using protein and energy dense oral supplement drinks containing Medium Chain Triglyceride (MCT Oil), Eicosapentaenoic Acid (EPA), and Fructooligosaccharides (FOS) fiber. These supplements may promote weight gain and may help increase strength, physical activity, and quality of life.

Keep a daily journal of the patient's diet after a Whipple procedure. This can be useful in keeping records of nutritional progress.