“In general, people with EPI should strive for a healthy diet with lean protein, fruits, vegetables, and whole grains,” says Arielle Leben, a registered dietitian with NYU Langone Health in New York City, who specializes in working with people who have gastrointestinal disorders. “Healthy fats such as salmon, avocado, and nuts are recommended, but with some modifications to optimize tolerance.” These modifications include portion control, spreading out intake of food throughout the day, and use of PERT therapy if recommended by a physician. Leben notes that paying attention to meal preparation is also important. “Foods that are steamed, baked, or grilled are preferred to frying,” she says.
Foods to Avoid With EPI
There aren’t any foods that people with EPI should specifically avoid, says Krista Maruschak, a registered dietitian with the Cleveland Clinic’s Center for Human Nutrition in Ohio. “EPI causes your body to not properly break down food resulting in poor digestion of nutrients, particularly fat,” she says. “However, this does not mean you should avoid certain foods or items that have fat in them, as it may be crucial to maintain your weight and nutrition status.” However, Leben advises sticking to healthy fats and staying away from unhealthy ones. “Avoid trans fats and limit saturated fats as much as possible,” she says. “They are typically found in red meat, processed meats, fried foods, and dairy products.”
Eating Habits With EPI
If your doctor has prescribed PERT medication to control symptoms of EPI, it is important to take it as directed. This means taking it with every meal. “It is essential to take PERT consistently with all meals and snacks in the recommended doses to ensure proper digestion and absorption of food,” Leben says. “Do not delay eating once you have taken your enzymes.” “Taking PERT properly will also ensure your symptoms of EPI are minimal, like diarrhea, bloating, abdominal pain, constipation,” says Maruschak. “You will be less likely to have vitamin and mineral deficiencies from taking your PERT properly.” Eating patterns and behaviors are another important part of managing EPI, says Leben. “Smaller, more frequent meals throughout the day are preferred over larger meals,” she says. “Remember to slow down and chew food well, as this can aid with digestion and absorption.” Maruschak advises eating at regular times every day and trying to have similar portion sizes at meals and snacks. “The consistency will help your doctor or registered dietitian to properly dose your pancreatic enzymes to maximize their benefit,” she says. And don’t forget to pay attention to your fluid intake. “Staying well hydrated is important, particularly for those with EPI suffering from diarrhea,” Leben says. “With severe diarrhea, be mindful of choosing an oral rehydration solution containing electrolytes.” Finally, discuss alcohol consumption with your doctor. “Excessive alcohol consumption can contribute to chronic pancreatitis, which is one of the underlying causes of EPI,” Leben says.
What to Know About Vitamins and Supplements With EPI
However, don’t start taking any vitamins or supplements without first talking to a healthcare provider. “Vitamins and supplements should be discussed with your doctor or registered dietitian, as they will be based on the individual and their lab work,” Maruschak says. Finally, Leben adds a note of caution about fiber. “While a diet full of fruits, vegetables, and whole grains is recommended, too much fiber at one time may interfere with enzyme absorption,” she says. “Discuss any fiber supplements or fiber-fortified foods in your diet with your doctor or dietitian.”
