Pancreatic insufficiency is common in pancreatic cancer patients and may cause vague abdominal discomfort, pain, abdominal distention, excessive flatus (gas), belching, diarrhea, steatorrhea (fat indigestion) and weight loss. Pancreatic enzyme replacement therapy should be considered for these patients. It has been shown that a combination of pancreatic enzyme replacement therapy, nutritional counseling and biliary drainage can prevent weight loss in patients with unresectable cancer in the head of the pancreas with pancreatic duct obstruction.
Reportedly about 25% of patients who have the Whipple procedure, the most commonly used operation for removing a pancreatic tumor, may suffer from malabsorption. Fat absorption usually cannot be restored to normal, but the goal should be to eliminate diarrhea, restore adequate nutrition and prevent weight loss. A dose of 30,000-40,000 units of lipase at each meal could achieve these results.
Prescription pancreatic enzymes as well as several non-prescription pancreatic enzymes are available. The amounts of enzymes in each can have huge variations. The recommended type and dose of enzymes is individualized for each person. It is important to discuss with your physician the appropriate type and dose.