If you have exocrine pancreatic insufficiency (EPI) – a condition that requires you to watch your diet carefully and take medicine with every meal – you may be leery about going out to eat. But, experts say, you don’t have to give up on dining out. You just need to prepare a bit beforehand and make a restaurant game plan.
First Step: Restaurant Recon
Doing “restaurant recon” means checking out your restaurant well before you go there.
- Look up menus online. Do they have foods that fit your diet? For most people with EPI, this means having low-fat options, including fresh vegetables, fruits, and grilled or broiled fish or lean meat.
- Call the restaurant and ask about food accommodations. Explain your diet restrictions and, if their menu doesn’t have options you’re looking for, see if they can make you something that does fit your needs. Often, restaurants can help if they know ahead of time.
- When you arrive, find out where bathrooms are so you aren’t hunting them down should your meal go south. You don’t want to have to spend time searching when the situation is urgent.
One way to help make eating out with EPI a successful experience is proper at-home preparation.
Eat first. Eat a snack or light meal before you go, so you aren’t so hungry you let your guard down. Otherwise, you could wind up devouring deep-fried mozzarella sticks (or other foods that aren’t likely to sit well). Choose a high-protein snack that will help keep you satisfied longer, so that you don’t arrive famished.
Keep pills cool. Pack your enzyme replacement pills in a bag or secure container. If it’s a hot day, be sure you don’t store them in a stuffy glove compartment or in the sun. Heat is kryptonite for PERT and can make your valuable and vital medication ineffective. (Temps 77 F and warmer are bad news; room temperature is best.)
Pack supplies. If you have a hard time swallowing pills and take them by mixing what’s inside the capsule in a spoonful of applesauce, gelatin, or yogurt, bring these items with you. Also consider packing extra beverages, such as a bottle of water to swallow pills with in case your server doesn’t refill your glass in time.
Talk to the Waitstaff
If your restaurant doesn’t have good options that fit your food plan, don’t be shy about asking for alternatives. You may even think about bringing a list of restrictions – made for medical reasons – that your server could take to the kitchen. For example, you could ask that they not use butter or cream in your food. This could be a helpful reminder, especially during a dinner rush when cooks are at their busiest.
Ask your server when your food is likely to arrive and how long the meal may take. This can help you plan when you may need to take your enzyme replacements. Remind your server you will need water or other drinks so you can swallow your capsules. If the meal has multiple courses, you may need to take pills a few times.
Eat This, Not That
Restaurant meals are known to often be larger and made with more fat than food you make at home. That could cause you to need more enzymes than normal.
Still, you can try to stick to foods that are easier on your system. For most people with EPI, recommended foods include:
- Healthy protein from fish and lean meats, instead of processed meats and red meat
- Entrées that are baked, broiled or steamed, rather than fried, glazed or sautéed
- Fresh fruits and vegetables, but without fat-filled, rich sauces slathered on (Instead, have these on the side, so you can control whether, or how much, you want.)
- Salads with vinegar or fresh lemon juice, instead of creamy dressings
- Veggies or salads as sides, rather than french fries or potato chips
- Low-fat appetizers like clear soup, steamed clams, or shrimp cocktail
- Sorbet or fresh fruit for dessert, in place of pie or cheesecake
You also may find that an appetizer works better than a large entrée, maybe with a dinner salad added. Or maybe you can split an entrée with someone else. Experts generally recommend eating smaller meals if you have EPI.
When it comes to alcohol, you’re better off skipping it, experts say.
Other food precautions:
- Avoid too much fiber, which can make it harder for the pancreatic enzymes to work.
- Limit processed foods, like bread, bacon, and cake.
Plan for Next Time
After your restaurant meal is over, consider whether you would go again and, if so, what you might change to make it an even better experience. If you were pleased with the place, add it to your (hopefully, growing) list of EPI-friendly restaurants near you.
The more you go out, the more you’ll learn about your local restaurants – their menus and willingness to help you meet your needs. Soon, your restaurant game plan will become second nature, and the joy of dining away from home with friends and family will be an ongoing source of pleasure.
Cleveland Clinic: “The Best (and Worst) Foods for Pancreatitis Pain.”
Creon: “Making healthy diet and lifestyle choices.”
Florida Digestive Health Specialists: “How to navigate eating out with digestive issues.”
Guts UK: “Pancreatic Enzymes & Pancreatic Exocrine Insufficiency,” “Tips and Suggestions.”
National Health Service (U.K.): “Eating processed foods.”
Nutrients: “Role of Fibre in Nutritional Management of Pancreatic Diseases.”
OncoLink: “Pancreatic Enzyme Replacement Therapy (PERT)”
Pancreatic Cancer Action Network: “8 Tips on Managing Exocrine Pancreatic Insufficiency.”
The National Pancreas Foundation: “Eat Healthy, Live Better,” “Fact Sheet – Dining Out,” “Nutrition Advice & Recipes.”