[jabbadabbadooba]

I have (idiopathic) Chronic Pancreatitis and I wonder if the same holds for me. I'm already on enzymes but not diabetic (yet, knock on wood). There is a link in the article pointing to Crohns so I have hope that there is some correlation. If anyone has any more info, I'd gladly hear you out as it could be life changing for me. For instance, if I'd want to try this myself, what could be a good off the counter medication (in EU)? And what would be a good interval of taking these? I notice that doctors are slow on the uptake with these kind of discoveries so I've become more prone to trying remedies (diet changes mostly) myself. (Note: I don't shun away from bad news, would like to hear that too)

[DoreenMichele]

I have a condition that can lead to pancreatitis, diabetes and usually involves digestive enzymes. I've successfully gotten off the digestive enzymes.

If you aren't already: I will suggest you keep a food and symptom journal, stay away from table salt (sea salt or kosher salt are both better) and figure out if you have trouble with specific oils. Symptoms can sometimes lag behind triggering events substantially. A journal can help you find patterns and make inferences.

I personally avoid peanut oil. It's very inflammatory and inflammation is has been linked to diabetes.

[jabbadabbadooba]

I've long put off having a food and symptom journal, because I'm pretty disorganized, but I will take your advice serious. Can I ask how you exactly correlate the symptoms with your food intake? From what I've read the digestive system takes max 48 hours from in to out.

[DoreenMichele]

I do a lot of reading. I discuss stuff a lot with my adult sons who still live with me. I look for patterns.

A lot of stuff happens about 48 hours after the triggering event. My son did some research and this seems to be a significant blood and lymph timing thing.

Other significant time frames seem to be one week, two weeks, one month and six weeks. These aren't peculiar to "things I ate." These are health events triggering physiological changes that don't show up until later.

It's harder to connect those longer time frames to the triggering event, but I am sometimes reasonably confident of the connection because of the specifics involved and I just read a lot and discuss this stuff a lot and write about it a lot. Patterns eventually become clear if you pay enough attention.

As your diet changes, your body changes and your needs change. It's a moving target.

[Ixiaus]

I don't have anything to address your questions but I am curious what dietary changes you've made.

[jabbadabbadooba]

Smaller meals; eating too much will lead to acute attacks. Multiple smaller meals is recommended with chronic pancreatitis. It's still a difficult thing to achieve, since eating 24/7 is kind of against human nature and going out you will have to forego it a lot. Also when the pancreatitis becomes acute I tend to pause large meals altogether, relying on yoghurt instead.

Limit sugar intake; limited sugar intake has health benefits and seems to help diabetics, so I've cut my sugar intake as well. Sometimes I cheat, but only once in a while.

I don't drink any alcohol whatsoever. Alcohol is an antagonist.

When pancreatitis is acute (or upcoming), I limit my caffeine intake and instead use coffee without caffeine. Caffeine is a trigger for pancreatitis. I still like my caffeine boost, but I rather forego it when my pancreas is acting up.

Smoking is very bad. I used to smoke and quit many times. It noticeably affects the pancreas. I've since exchanged it with vaping and don't notice it affecting my pancreas. There is research out there that nicotine by itself is an anti inflammatory agent; still I want to quit vaping too but have other issues that interplay too.

There are other small things too (like I take my yoghurt every morning religiously and sleep on my right side mostly). The above is a summary of the most important things that are evidence based and known to work with pancreatitis.

I haven't had a full blown acute attack in a year or two (I lost track a bit), but sometimes I have smaller attacks that don't require me to go to the hospital. I then limit my intake of food (and drink only the necessary to stay hydrated). The thing with Chronic Pancreatitis is also that it may stabilize after a while due it 'failing to attack itself' because it cannot produce its own enzymes anymore. That may be the case for me too as my pancreas is severely calcified.

[Ixiaus]

Interesting, thanks for sharing. I haven't had any acute illnesses that drove my own dietary changes but I too have completely cut alcohol and refined sugar from my diet and I generally feel great in my body. I did strict Keto for about 8 months (less than 10 net grams of carbs per-day) and it made me feel really good but I couldn't keep it up with weightlifting. Nowadays I follow a low-ish carb paleo diet which makes me feel pretty good and seems to strike the right balance between healthy fats and okay carbs.

[jabbadabbadooba]

Thanks for your input too. I've looked into lowering carbs but I'm raised on pasta. I find it kind of hard to replace. Do you have any suggestions? I generally don't have a lot of patience or energy for cooking anyway, so changing the type of food I eat is a challenge for me.

[Ixiaus]

Sorry for the late reply.

First of all, I don't think pasta is too terrible if it's fitting in your macros. Wheat will have a larger glycemic impact on you though than many other carbohydrate sources (e.g. sweet potatoes, which I consider a super food for humans, alongside eggs).

The most important thing about diet change is to resist making big, dramatic changes. Think in terms of weak signals: figure out what foods would be easy to meal prep for, that you like eating, and would be good combined together in simple ways. By simple I mean very simple, pick two major macros (carbs and protein, or fat and protein). Once you've got that figured out and you've decided how to combine them, then you can add easy low-effort accessories at meal time.

I ended up landing on what I call a "power bowl" dinner meal that I eat every single night (I haven't tired of it yet) consisting of:

Mains:

- Main 1: 150 grams of sweet potato (cubed and baked with some olive oil and salt)

- Main 2: 10oz of a main protein (I rotate between chicken, cod, pork, and burger patties)

Accessories:

- 2 cups of spinach

- optional fried egg

- tomato / onion

- zero carb rosemary dressing (high fat though)

It's extremely easy to meal prep, very easy to weigh and measure, it tastes really good, great mix of macros, the carbohydrates from sweet potatoes have a low glycemic impact (unlike anything made from wheat), and I get a lot of protein. If it gets boring I can add a fried egg, or goat cheese, or change the protein, or add some green chiles, etc. so creating novel flavors is easy and doesn't require significant prep time.

At some point I'm going to start growing my own sweet potatoes and spinach at which point I only need to buy my protein and other add-ons.

I also don't have patience or energy to cook, one of my early-20s favorite meals was white rice with canned meat sauce. I don't eat that anymore but the trick to changing what you eat is to:

- Keep it simple

- Keep it whole (as in "whole food")

- Meal prep the bulk items (you can bake sweet potatoes and chicken/cod/pork in less than an hour on Sunday, then assemble the bowls easily at night)

Making it easy and simple to assemble will help keep you from convincing yourself you're too tired and should just run to Chipotle :-p This is why I like the power bowls because they don't require any special timing, or prep, or techniques, or specialized ingredients (unless you want them).

That's all for dinner. I stay fasted through breakfast and I usually eat 5 eggs with 4 slices of high-quality bacon for lunch. I have lots of nuts, fruits, and paleo granola for snacks.

[tcoff91]

I’m curious if an extended (1-2 weeks) fast could help. If eating is what bothers it maybe an extended break could help? Fasting seems to help a variety of other medical conditions.

[jabbadabbadooba]

Yes, there is recent evidence regarding this with pancreatitis too. I fast whenever I sense my pancreas is inflamed (as is also customary in hospital visits - practically the only treatment). However I'm bordering (sometimes crossing) underweight so I don't do it regularly.

[onemoresoop]

Recent thread on HN that I recommend reading

[0]: https://news.ycombinator.com/item?id=18202118

[treeman79]

Ever looked at Sjogren? Pancreatitis is a precursor

[jabbadabbadooba]

Thanks for the suggestion. I will look into it.

[phkahler]

I'll suggest trying iodine. Some claim it helps diabetics, and I found it to help blood sugar as well. Then try glycine - i know someone with crohn's who said it helped.

[jabbadabbadooba]

I've actually long eliminated salt (iodine) from my diet, because of various reports that it wasn't beneficial, but am now coming back on that. Thanks for telling me that. From what I read glycine is in nuts and meat, I'll have to read more on its properties.

[nicwilson]

Iodine is required for thyroid function, so _no_ Iodine is very bad. Trace amounts form diet may be enough (disclaimer IANADietician), but pretty much all the table salt we buy and use is Iodised.

[ImprovedSilence]

I've noticed that all the sea salts I see, especially anything that comes in a grinder is increasingly not iodized these days. It's like I have to try and buy regular morton salt in a huge cylinder and not fancy hip salt if I want iodized salt anymore.

[DoreenMichele]

Salt is an important component of the mucus lining your gut.