Diet for Patients with Pancreatic Insufficiency

26th November 2019
The pancreas is an important gland and can experience problems that go beyond diabetes. Are you familiar with them?

Pancreatic insufficiency is the progressive loss of pancreatic function. Acute pancreatitis is another condition that refers to temporary inflammation. If you suffer from these conditions, how should you structure your diet?

The pancreas

The pancreas is a gland with two main functions: endocrine and exocrine. The endocrine function is responsible for producing hormones such as insulin, glucagon, somatostatin, gastrin and pancreatic polypeptide.

On the other hand, the exocrine function is responsible for secreting pancreatic enzymes such as amylase, lipase, and trypsinogen.

The importance of pancreatic secretion

As with the liver, pancreatic secretion plays an important role in metabolizing all macro-nutrients. The body depends on the bile acids and pancreatic secretion to digest fat. Of all the nutrients, pancreatic insufficiency or hepatic problems affect fat the most.

As for proteins, the body depends on other mechanisms to absorb them such as pepsin in gastric juices. Thanks to the fact that there are other mechanisms in play, the body can still digest proteins even if the pancreas fails. Similarly, the body relies on additional mechanisms as well to digest carbohydrates.

Acute pancreatitis

In Spain, there are no recent records regarding acute pancreatitis. However, it’s the third cause of hospitalization in the United States and is the fifth cause of death among non-malignant diseases. Acute pancreatitis can be mild or develop into multi-organ failure.

Chronic pancreatitis

Chronic pancreatitis is characterized by irreversible inflammatory damage that causes pancreatic atrophy and fibrosis, which leads to pancreatic insufficiency.

pancreatic insufficiency chronic

Diabetes comes into play as a result of the failing endocrine function. In addition, exocrine failure also leads to diarrhea, which results from the poor absorption of fats, which is known as steatorrhea.

Causes

Pancreatitis can result from toxic-metabolic, idiopathic, genetic or autoimmune problems. Alcohol or tobacco use can also lead to pancreatic problems. Cystic fibrosis is an example of a problem of genetic origin while Sjorgren’s syndrome is an example of an autoimmune origin.

A suitable diet for pancreatic insufficiency

The main goal in pancreatic insufficiency diets is to maintain a level of nutrition or to revert malnutrition in the case that the body already lacks what it needs. Malnutrition and hyperphagia are common among patients, which both contribute to loss of muscle mass.

Patients that show symptoms of malnutrition and hyperphagia consume an excess of calories, which derive from fat-rich foods, in an attempt to reverse weight-loss. As a consequence of consuming more fats, they suffer from diarrhea and their bodies don’t receive the nutrients and vitamins they need.

Another goal in these diets is to control blood sugar in order to prevent diabetes from progressing. Diabetes can create the need for insulin therapy. To prevent it, patients can follow a low-glycemic diet.

The third goal in pancreatic insufficiency diets is to ensure that the body is absorbing foods properly. Patients undergo tests to determine how their bodies are absorbing micro- and macro-nutrients as well as monitoring the bowel movements for diarrhea. The diets are tailored to each patient to ensure the best level of absorption.

A nutritionist must be part of the plan to formulate a healthy meal plan that has an appropriate carbohydrate and protein intake.

Lastly, but certainly not any less important than all of the above, the right diet has to consider the possible deficits that might result from the pancreatic disease. Tests have to check the fat-soluble vitamin and mineral levels in order to prevent further complications.

pancreatic insufficiency diet

Pancreatic insufficiency: meal plan

The main recommendation for pancreatic insufficiency patients is to follow a healthy, balanced diet that includes appropriate portions of the macro-nutrients. In addition, patients should also divide up their diets into smaller meals throughout the day to prevent digestive problems.

Most importantly, patients have to control the amount and type of fats that they consume. Plant-based fats and medium-chain triglycerides, MCTs, are the most recommendable sources. Patients can also use pancreatic enzyme medication to help digest fats as long as they’re prescribed to suit their meal plan.

As for carbohydrates, how much a patient should consume depends on their pancreas’ endocrine function. In addition, portions and the number of meals will depend on if the patient suffers from diabetes or not. As long as no other organs are affected, protein consumption recommendations follow an international norm.

Lastly, patients might need supplements for fat-soluble vitamins, which are vitamins A, D, E and K.

  • Everhart JE, Ruhl CE. Burden of digestive diseases in the United States Part III: Liver, biliary tract, and pancreas. Gastroenterology. 2009;136:1134-44
  • Lowenfels AB, Maisonneuve P, Sullivan T. The changing character of acute pancreatitis: epidemiology, etiology, and prognosis. Curr Gastroenterol Rep 2009;11:97-103