When you have exocrine pancreatic insufficiency (EPI), you need to take extra care with what and how you eat. The condition means your pancreas doesn’t make enough of the enzymes you need to properly break down the proteins, fats, and carbohydrates in your food. You may not get enough nutrients.

But it is possible for you to eat and feel well when you have EPI. Work with a dietitian so you can know exactly how to get proper nutrition in your meals and snacks without making your symptoms worse. And keep a few basic tips in mind.

Eat several smaller meals throughout the day. With EPI, it may be hard to make yourself eat, much less sit down for three big meals a day. Try eating a little at a time five or six times a day. It can help you feel more comfortable.

Stick with a low-fat diet. Your body has an especially tough time digesting fat, so you need to avoid getting too much. It’s especially important to avoid saturated and trans fats. In general, you shouldn’t eat more than 20 grams of fat each day or more than 10 grams of fat at one meal. Find ways to cut it out of your diet, like eating grilled or baked foods instead of fried, using cooking spray instead of oil or butter, and choosing low-fat or fat-free dairy.

Go for lean proteins, like chicken or turkey breasts, egg whites, or tuna packed in water. This will provide your body with the fuel it needs while keeping your meals low in fat.

Avoid too much fiber. Though it’s usually part of a healthy diet, fiber can keep your pancreatic enzymes from digesting fat as well. Ask your dietitian about foods that have a lot of it, like lentils and beans.

Be careful with processed foods. Packaged snacks, frozen dinners, and the like can have partially hydrogenated oil in their ingredients, which adds more unhealthy fats. Check nutrition labels and ingredient lists before you buy.

Eat enough calories. If you take in a variety of foods with a range of nutrients and the right amounts, you have a better shot at getting what your body needs.

Take vitamin supplements. Since you can’t digest fats properly, you won’t get the vitamins that your body has to absorb through fat, called fat-soluble vitamins -- A, D, E, and K. Your doctor may give you a prescription for these.

Don’t drink too much alcohol. It can make your symptoms worse. It’s also a common cause of chronic pancreatitis, which in turn is the leading cause of EPI. It might be best to avoid alcohol entirely, since it can make you dehydrated and inflame your pancreas.

But drink plenty of fluids. It’s a good idea to keep a bottle of water with you to make sure you stay hydrated.

Take a pancreatic enzyme replacement therapy every time you eat. This supplement, the main treatment for EPI, helps your body break down food so that you get enough nutrients.

Sometimes you need to rest. If your pancreas is acting up, your doctor may advise a break from food for a few days. If you’re having a lot of pain, they may tell you to sip just clear liquids, like broth, or apple or cranberry juice. But don’t stop eating without talking to your doctor. When you can tolerate food again, you’ll be back to eating.

WebMD Medical Reference

WebMD Voices

Matt E., 58
Sinking Spring, PA
If you’re newly diagnosed, take comfort in knowing it typically takes weeks, if not months, to get your diet and enzyme dosing dialed in to where EPI symptoms may be under control. Don’t get too worried by bad days early on.
Jane C., 62
Phoenix, AZ
'No alcohol' goes without saying. If you’re socializing, try virgin drinks or simple club soda and lime. Fluid intake is important. I don’t go anywhere without my water bottle. I drink coffee on good mornings, tea in the evening, and ginger ale on tough days.
Roberta L., 63
Santa Ana, CA
When you're away from home, it’s good to know where restrooms are. There are apps out there like "Sit or Squat" and "Flush". You put in your location and it gives you the nearest bathrooms. Keep or carry an extra set of clothes in case of emergency.
Joe V., 79
Winneconne, WI
Look for a good support system -- friends, family, other survivors. Keeping positive people around you helps you get through the tougher days. It’s important to remain hopeful. I’m a 14-year pancreatic cancer survivor. A positive attitude and keeping my faith helps.
Jane C., 62
Phoenix, AZ
It’s easy to feel isolated with food restrictions. I eat before we go so I’m not hungry and tempted to eat something that may make me sick. With family or close friends, I bring my own meal. They’re happy to let me heat it up, and it takes pressure off them.
Roberta L., 63
Santa Ana, CA
It's not always easy, but a positive attitude really helps. Find a quote, write it down, and carry it with you. When things get tough, read it. My favorite is: Fate whispers to the warrior, ‘You cannot withstand the storm.’ The warrior whispers back, ‘I am the storm.
Liz J., 32
San Francisco
Some days are better than others -- and symptom severity can be influenced by our mental health and how we relate to the pain and discomfort. Meditation and deep breathing exercises have gotten me through some pretty intense episodes.

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