Post Whipple Nutrition / Digestion

My Mother had a Whipple procedure in Sept. 2005 for bile duct cancer.  There was involvement of one lymph node on the pancreas.  She had subsequent radiation and chemotherapy although the chemo regime was shortened due to extremely bad side-effects.  She has also had colon cancer in 2001 and ended up with a permanent colostomy.

Her problem now is very bad diarrhea with an oily/fat discharge.  The oily discharge causes her colostomy appliance to come loose from her abdomen several times per day.  It appears to dissolve the seal material.  Her appetite is good, but she does not put on any weight due to the extreme diarrhea.  She takes the pancreatic enzymes with every meal.  She has also had several month long courses of IV antibiotics due to a an abcess near her sacral area caused by earlier radiation from the colon cancer.  She gas been off of the antibiotics for 4 weeks, but the oily diarrhea only seems to get worse.

Any suggestions would be appreciated.

Thanks

Hi- I am a registered dietitian.  It is possible that the antibiotic therapy could have caused diarrhea by upsetting the intestinal flora of the large intestines.  But the oily stool is likely due to fat malabsorption from having the Whipple surgery.  Your mother needs to increase the amount of pancreatic enzyme she takes at meals.  Try taking 2 per meal, with the first bite.  She needs extra digestive enzymes to break down the fat so that it can be absorbed.  Also, make sure she is taking in adequate fluids to protect her from dehydration from the diarrhea.  Also, she needs a daily liquid multivitamin to protect her from fat-soluble vitamin deficiency. 

My husband had the Whipple on November 28, 2006.  He had the same symptoms oily stools and he seemed to go 2-3 times a day.  He went to see the radiation nutrionist and she told him to increase his pancreatic enzymes.  She said for every 15 grams of fat you eat take a pill.  He has done that and since the end of February has gained 7 pounds and only goes to the bathroom once a day. 

Good Luck!