Do Post-whipple Patients Have Difficulty Absorbing Vitamin D?

A Whipple procedure is a major operation that involves removal of your gallbladder, the first portion of your small intestine and a portion of your pancreas. Part of your stomach may also be removed. Surgeons most commonly perform a Whipple procedure to remove a cancerous tumor from the pancreas or bile duct. Depending on the percentage of your pancreas removed during the procedure, you may have difficulty digesting fats and absorbing fat-soluble vitamins, including vitamin D, after your surgery.

Fat Malabsorption

Your pancreas produces digestive enzymes that break down fats, protein and carbohydrates. When the surgeon removes part of your pancreas, production of these digestive enzymes may be insufficient to accomplish normal food breakdown. Signs and symptoms of poor fat digestion include weight loss, diarrhea, oily stools, excess intestinal gas and abdominal pain, especially after eating a fatty meal. If you are not digesting fats normally, absorption of vitamin D and other fat-soluble vitamins from food is also impaired.

Digestive Enzyme Replacement

If you have symptoms of impaired food breakdown and absorption after a Whipple procedure, your doctor may prescribe digestive enzyme supplements. You take these medications with meals and snacks to boost the level of digestive enzymes in your intestines, enabling you to break down food and absorb the contained nutrients and vitamins.

Vitamin D from Food

Including vitamin D-rich foods in your diet may help prevent development of a deficiency after a Whipple procedure. Options include vitamin D-fortified cereal, milk and juice; beef liver; egg yolks; tuna; wild salmon; sardines; and mackerel. Some people have difficulty tolerating milk and milk products after a Whipple procedure. Talk with doctor if you experience bloating, abdominal cramps and diarrhea associated with eating dairy products. Enzyme supplements that break down milk sugar may alleviate the problem.

Vitamin and Mineral Supplements

Your doctor is likely to recommend that you take a daily multivitamin after your Whipple procedure. Additionally, many doctors recommend supplemental vitamin D and calcium. Talk with your doctor about whether you should take supplemental vitamin D and calcium. Do not take any over-the-counter nutritional supplements or herbs without first discussing it with your doctor.

Dietary Fat Intake

If you continue to have symptoms of impaired fat digestion with enzyme replacements, your doctor may recommend a low-fat diet. Foods to avoid include butter, oils, whole milk, cream, fatty meat and fried foods. Your doctor may prescribe a fat supplement containing medium-chain triglycerides to prevent weight loss; the supplement is easier to digest and absorb than the usual dietary fats. Your doctor may also increase in your daily dose of supplemental vitamin D and calcium.