A nurse is providing dietary teaching for a client who has chronic pancreatitis

Overview | Causes | Genetics | Symptoms | Diagnosis | Treatment | Auto Islet Transplants | Diet | Prognosis | FAQ

Nutrition is a vitally important part of treatment for patients with pancreatitis. The primary goals of nutritional management for chronic pancreatitis are:

• Prevent malnutrition and nutritional deficiencies
• Maintain normal blood sugar levels (avoid both hypoglycemia and hyperglycemia)
• Prevent or optimally manage diabetes, kidney problems, and other conditions associated with chronic pancreatitis
• Avoid causing an acute episode of pancreatitis

To best achieve those goals, it is important for pancreatitis patients to eat high protein, nutrient-dense diets that include fruits, vegetables, whole grains, low fat dairy, and other lean protein sources. Abstinence from alcohol and greasy or fried foods is important in helping to prevent malnutrition and pain. 

Nutritional assessments and dietary modifications are made on an individual basis because each patient’s condition is unique and requires an individualized plan.  Our Pancreatitis Program offers nutritional and gastrointestinal support for those with pancreatitis.

Vitamins & Minerals 

Patients with chronic pancreatitis are at high risk for malnutrition due to malabsorption and depletion of nutrients as well as due to increased metabolic activity. Malnutrition can be further affected by ongoing alcohol abuse and pain after eating. Vitamin deficiency from malabsorption can cause osteoporosis, digestive problems, abdominal pain, and other symptoms.

Therefore, patients with chronic pancreatitis must be tested regularly for nutritional deficiencies. Vitamin therapies should be based on these annual blood tests. In general, multivitamins, calcium, iron, folate, vitamin E, vitamin A, vitamin D, and vitamin B12 may be supplemented, depending on the results of blood work.

If you have malnutrition, you may benefit from working with our Registered Dietitian who can guide you towards a personalized diet plan.

Risk of diabetes in chronic pancreatitis

Chronic pancreatitis also causes the pancreas to gradually lose its ability to function properly, and endocrine function will eventually be lost. This puts patients at risk for type 1 diabetes. Patients should therefore avoid refined sugars and simple carbohydrates. 

Enzyme Supplementation

If pancreatic enzymes are prescribed, it is important to take them regularly in order to prevent flare-ups.

The healthy pancreas is stimulated to release pancreatic enzymes when  undigested food reaches the small intestine. These enzymes join with bile and begin breaking down food in the small intestine.

Since your pancreas is not working optimally, you may not be getting the pancreatic enzymes you need to digest your food properly. Taking enzymes can help to digest your food, thus improving any signs or symptoms of steatorrhea (excess fat in the stool, or fat malabsorption). In turn this will improve your ability to eat better, lowering your risk for malnutrition.

Alcohol

If pancreatitis was caused by alcohol use, you should abstain from alcohol. If other causes of acute pancreatitis have been addressed and resolved (such as via gallbladder removal) and the pancreas returned to normal, you should be able to lead a normal life, but alcohol should still be taken only in moderation (maximum of 1 serving/day). In chronic pancreatitis, there is ongoing inflammation and malabsorption — patients gradually lose digestive function and eventually lose insulin function — so regular use of alcohol is unwise.

Smoking

People with pancreatitis should avoid smoking, as it increases the risk for pancreatic cancer.

Next Steps

If you or someone you care for is dealing with a pancreatitis, the Pancreas Center is here for you. The Pancreatitis Program works with nutritionists to provide helpful diet suggestions that help manage the impact of the disease. 

Call us at (212) 305-4795 or use our online form to get in touch today.

To keep learning about pancreatitis:

Overview | Causes | Genetics | Symptoms | Diagnosis | Treatment | Auto Islet Transplants | Diet | Prognosis | FAQ

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• Pancreatitis Program
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Related Topics

This is a quiz that contains NCLEX review questions for pancreatitis (acute and chronic). As a nurse providing care to a patient with pancreatitis, it is important to know the signs and symptoms, pathophysiology, nursing management, diet education, and complications.

In the previous NCLEX review series, I explained about other GI disorders you may be asked about on the NCLEX exam, so be sure to check out those reviews and quizzes as well.

(NOTE: When you hit submit, it will refresh this same page. Scroll down to see your results.)

1. Inside the pancreas are special cells that secrete digestive enzymes and hormones. The cells that secrete digestive enzymes are known as ______________ cells.

A. Islet of Langerhans

B. Protease

C. Acinar

D. Amylase

2. From the pancreas and gallbladder, the common bile duct and pancreatic duct open into the ____________ where digestive enzymes and bile flow through the duodenum via the major duodenal papilla which is surrounded by a muscular valve that controls the release of digestive enzymes known as the ______________.

A. ampulla of vater, sphincter of Oddi

B. papilla of vater, sphincter of Oddi

C. minor duodenal papilla, ampulla of vater

D. jejunum, sphincter of pylori

3. Select-ALL-that-apply: In the pancreas, the acinar cells release:

A. Amylase

B. Somatostatin

C. Lipase

D. Protease

4. You’re caring for a 45 year old patient who is admitted with suspected acute pancreatitis. The patient reports having extreme mid-epigastric pain that radiates to the back. The patient states the pain started last night after eating fast food. As the nurse, you know the two most common causes of acute pancreatitis are:

A. High cholesterol and alcohol abuse

B. History of diabetes and smoking

C. Pancreatic cancer and obesity

D. Gallstones and alcohol abuse

5. Which patient below is at MOST risk for CHRONIC pancreatitis?

A. A 25 year old female with a family history of gallstones.

B. A 35 year old male who reports social drinking of alcohol.

C. A 15 year old female with cystic fibrosis.

D. A 66 year old female with stomach cancer.

6. Your patient with acute pancreatitis is scheduled for a test that will use a scope to assess the pancreas, bile ducts, and gallbladder. The patient asks you, “What is the name of the test I’m going for later today?” You tell the patient it is called:

A. MRCP

B. ERCP

C. CT scan of the abdomen

D. EGD

7. A patient is admitted to the ER with the following signs and symptoms: very painful mid-epigastric pain felt in the back, elevated glucose, fever, and vomiting. During the head-to-toe assessment, you notice bluish discoloration around the belly button. As the nurse, you know this is called?

A. Grey-Turner’s Sign

B. McBurney’s Sign

C. Homan’s Sign

D. Cullen’s Sign

8. While assisting a patient with chronic pancreatitis to the bathroom, you note the patient’s stool to be oily/greasy in appearance. In your documentation you note this as:

A. Steatorrhea

B. Melena

C. Currant

D. Hematochezia

9. A patient with acute pancreatitis is reporting excessive thirst, excessive voiding, and blurred vision. As the nurse, it is priority you?

A. Reassure the patient this is normal with pancreatitis

B. Check the patient’s blood glucose

C. Assist the patient with drinking a simple sugar drink like orange juice

D. Provide a dark and calm environment

10. A patient who received treatment for pancreatitis is being discharged home. You’re providing diet teaching to the patient. Which statement by the patient requires immediate re-education about the diet restrictions?

A. “It will be hard but I will eat a diet low in fat and avoid greasy foods.”

B. “It is very important I limit my alcohol intake to no more than 2-3 glasses of wine a week.”

C. “I will concentrate on eating complex carbohydrates rather than refined carbohydrates.”

D. “I will purchase foods that are high in protein.”

11. The physician orders a patient with pancreatitis to take a pancreatic enzyme. What assessment finding demonstrates the pancreatic enzymes are working properly?

A. Abdominal girth is decreased

B. Skin turgor is less than 2 seconds

C. Blood glucose is 250

D. Stools appear formed and solid

12. During a home health visit, you are assessing how a patient takes the prescribed pancreatic enzyme. The patient is unable to swallow the capsule whole, so they open the capsule and mix the beads inside the capsule with food/drink. Which food or drink is safe for the patient to mix the beads with?

A. Pudding

B. Ice cream

C. Milk

D. Applesauce

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