Biliary inflammation (gallbladder disease, SOD), acute and chronic pancreatitis are all made worse by consuming high fat meals. It’s a fact. A fact I know from personal experience and from scientific evidence. Many of you who have read my blog(s) may be wondering …
Why does fat consumption increase the risk of acute pancreatitis in those who have previously experienced pancreas damage? Why does fat exacerbate other biliary conditions such as gallbladder disease and sphincter of oddi dysfunction?
I have been telling people, who have experienced recurrent acute pancreatitis and/or have been diagnosed with chronic pancreatitis, that fat is an enemy to avoid. It is an enemy of anyone who suffers from biliary inflammation yet, I have never explained WHY. So …
I thought it might be time to explain as best I can exactly why avoiding certain fats and drastically limiting other fats is beneficial for those of us who have suffered pancreas damage due to pancreatitis. The subject is involved and often conflicting, in regards to evidence, and you may find it boring but …
I am hoping that with the increase of knowledge regarding fat and it’s role in biliary inflammation that you’ll understand why a low-fat diet is extremely beneficial for those who suffer from pancreatitis and other biliary conditions. Sometimes testimonials such as these from my FB page:
It was a year last week since he’s been following this diet Marianne Birtchnell and yes doing really wellUnlike · Reply · 2 · May 22 at 3:52pm
I found this blog when my doctor just left me hanging when I first was diagnosed. Have been following this regimen the past six months and feel pretty much free of pain. Worth exploring his time tested suggestions.Unlike · Reply · 2 · May 22 at 8:43am
“Hi!
I thought I´d share my story on this post since I got some very happy news yesterday.A little under a year ago I was diagnosed with chronic pancreatitis after several bouts of stomach pain over a period of about five years, the last one lasting for several weeks with fever and everything.I was sent to ultrasound and there the radiologist found scar tissue having formed in my pancreas and he said that this was caused by inflammation of the pancreas due to drinking too much (which is what caused the attacks) and ordered me to stop drinking altogether. I haven´t touched alcohol since.Shortly after I came over this blog and adopted the regime of a low fat diet, grape seed, vitamin C, curcumin and enzymes before meals. I also took Ibuprofen whenever I felt the slightest sign of pancreatic stomach pain (you kinda know how it feels if you´ve had it before). I also made sure to get cardio-vascular exercise at least three times a week and have a certain amount physical activity every day (walks, biking etc). CT-scan Yesterday I got the results from a recent CT scan, (which is a more precise form of diagnosis than ultrasound) and to my surprise they found “no evidence of disease in pancreas”. This means that the scarring in my pancreas has healed in less than a year and I stand a much better chance of escaping this horrible disease, and the future looks bright!I will continue to stay away from alcohol, and will also continue to take supplements, although maybe not as many as before, just to stay on the safe side.This goes to show that there is indeed hope if you get an early diagnosis and implement measures immediately and stick to them.”The above comment was posted on my other blog. You’ll have to find it but you can read it in original form here.
Sometimes a person simply needs a viable explanation backed up by scientific proof (studies) that at least suggests that what someone says (me) is actually beneficial for someone else (you). So we may as well get on with it. 🙂
Biliary Inflammation – WHY Is Fat Bad?
Simply put fat is inflammatory and high fat meals produce postprandial inflammation [1]. Most studies regarding fat and the inflammation caused by consuming high fat meals is geared towards heart disease yet high fat meals may cause inflammation of brain tissue as well at least it does in mice brain tissue [2]. Yet, if you recall, grapefruit juice coupled with a low fat diet originally stopped my acute pancreatitis attacks. Then while writing about my experiences I found a study done on rats that pointed to grapefruit as being the potential real friend [3]. So …
Since high fat meals contribute to inflammation in the cardiovascular system and brain tissue high fat meals most certainly do the same within the biliary tree (liver, pancreas, gallbladder, sphincter of oddi). Yet there may be other mechanisms besides inflammation at work as well.
Lipase, as most pancreatitis warriors know, is an enzyme that catalyzes the hydrolysis of fats (lipids). It is manufactured and secreted in the largest quantities by the pancreas to aid in the digestion of fats. When a high fat meal is eaten the pancreas has to work more to produce and secrete more lipase to handle the fat. Making an already damaged pancreas work more on top of the inflammatory meal may also contribute to problems BUT I can find no proof. It may simply be the offending, inflammatory fat.
For those with gallbladder disease (with or without stones) and sphincter of oddi dysfunction high fat foods can inflame the gallbladder just as they do the pancreas and bile flow is stimulated by high fat foods [4].
The increase in bile flow coupled with inflammation most likely causes the GB to eject stones and sludge when stones or sludge are present. These ejected stones and/or sludge could inturn obstruct the common bile duct or pancreatic duct and cause gall stone pancreatitis.
For those with SOD (sphincter of oddi dysfunction) the biliary inflammation along with increased bile flow could irritate the SO, cause it to spasm, which in turn could cause mild to severe SOD symptoms and acute pancreatitis. Spasms cause acute pancreatitis due to the sphincter closing causing bile along with other digestive juices to back up into the pancreatic duct.
Are ALL Fats Bad?
Yes. No matter what class of fat, trans fats (hydrogenated garbage) found in processed foods, saturated fats (meat, fish, poultry, water fowl, dairy), monounsaturated fats (nuts, seeds, cooking oils) or polyunsaturated fats (plant sources), all fat groups are not conducive to pancreas healing. Fat is fat yet polyunsaturated fat seems to be tolerated more easily than the other fats in those of us who have pancreatitis. Ya but …
What About Omega 3’s Found In Olive Oil, Flax Seed and Fish?
I have to admit this is where it is very confusing, contradicting and down right baffling. Good fats, omega 3 fatty acids, found in cold water fish (salmon, sardines, mackerel, tuna), fish oil, olive oil and flax seed are actually ANTI-inflammatory yet they will still cause problems in those who are at risk for biliary inflammation (e.g. pancreatitis)
WHY?
I don’t have a good answer and I can’t find any scientific research stating why they would ignite inflammation in our pancreas or other biliary tree organs, they just do. If you haven’t sustained a lot of damage and are healed up nicely you may tolerate small amounts of cold water fish, olive oil and flaxseed. Then again maybe not. Test them yourself if you dare. Just remember I warned you. 🙂
References:
1) A high-fat meal induces low-grade endotoxemia: evidence of a novel mechanism of postprandial inflammation – Read
2) High-fat diet rapidly induces hypothalamic inflammation in mice – Read
3) Extract of grapefruit-seed reduces acute pancreatitis induced by ischemia/reperfusion in rats: possible implication of tissue antioxidants – Read
4) Effect of fat pre-feeding on bile flow and composition in the rat – Read
How do you get essential fatty acids into your diet. So far for the past week eliminating fats has brought me relief but I doesn’t my body need some fats…
Hi Lew! Glad to hear you are better. Your body may need some fats but you get some polyunsaturated fat (plant fat) from veggies. You also get some fats from chicken and fish. Fish have essential fatty acids, omega 3’s. One week without omega 3’s isn’t gonna kill you. Neither will 6 months. The important thing is to heal the pancreas damage. I don’t know how many acute attacks you’ve had, the severity or how much damage you have sustained. Healing should be your top priority.
We are on a clinical trial and need to keep lipase levels normal, they fluctuate from other drugs and food, what is the best diet to keep lipase levels low. Also if you have a headache and advil increases lipase – how many days before bloodwork does it affect your lipase levels?
Hi Sam – the best diet to keep lipase levels normal is low, low fat, no alcohol. I am not aware that Ibuprofen increases lipase levels – that would be an oxymoron since it reduces inflammation which in turn usually reduces lipase levels. I don’t see how Ibuprofen would both reduce inflammation thereby reducing lipase levels and increase lipase. If you have any proof of that share it because that would be interesting to say the least.
Hi health guy, you can call me stupid but this morning I had a matcha latte made with almond milk . Big mistake! Thought it would be alright because only has 2% fat. But I was an idiot who has been feeling sick straight after it and all day. Good lesson for me. Another quick question though, is it normal to get sore and tired very easily? If I try to do the housework at home or floors or even walking around the mall for a period, i just get so tired? Is this normal?
Hi Stacey – well you learned something right? About your questions – Let me ask one cuz I don’t recall – How many acute attacks have you had and how long ago was the last? It can take months to totally heal, especially if it was more than a typical mild attack. If you have been on the modified vegan diet for more than a month you may need vitamin B12. That is why I suggest people get ALL One (multi vitamin/mineral) supplement. It seems to be the best and provides the best form of B12. I’m sure something else is out there that may be just as good but I know ALL One is good. So is fatigue common, yeah, it seems to be. Whether due to the illness or diet or a combination it is a common problem.
Hi HG
Have you heard of spirulina? It looks like a good super food but has plant fat. Any thoughts ? ?
Stacey – HUGE superfood. Part of the blue-green algae family. High in protein and tons of phytonutrients. I wouldn’t worry about the fat as long as you don’t eat a whole pound lol
I got this from over-boozing for 20+ years. I remember the doctor just saying low fat/low sugar & zero alcohol. Not drinking had been pretty hard, but I notice that now that I’m sober I want to stuff myself with food & that doesn’t work out very well. Also, I’ve been skinny my whole life, now losing weight from not eating enough. Anyone know the trick to this conundrum?
Hi Joe the only thing I can suggest is to try more protein (safe protein – no red meat or pork) and see if you tolerate it.
Hi! My Chiropractor says that my Pancreatitis is caused by thickened bile in my gallbladder. I’ve had gallbladder disease for 7 years..sludge mostly. And he said healing the gallbladder will heal the pancreas, and the only way to thin the bile is to drink 1Tbl of olive oil with lemon every night. I was thinking of trying this after my acute symptoms are gone but after reading your blog I’m afraid I’ll get a Pancreatitius attack. It seems that if I heal the Gallbladder which is the foundation, than the Pancreas will heal and I can eat a more normal diet. (not SAD) but healthy fats. What do you think?
Hi Carol – bile super-saturation with cholesterol is definitely a cause of gallstones. In fact women of child bearing age are more susceptible to this because of the lack of iron. This subject was brought to my attention by another reader and when I get time I am going to write a post about it. IF it were me I’d eat more iron rich foods (preferably foods rich in heme iron). Clams, oysters, fish, chicken (chicken liver is a great source but fairly high in fat so eat sparingly). Non-heme iron isn’t used as easily by the body but rich sources are spinach, beet greens, chard, beans, peas, lentils etc. You can enhance absorption and usage of non-heme iron by eating foods high in vitamin C along with the non-heme iron rich foods.
Oil is not good for an already damaged pancreas and the combination of olive oil and lemon juice will cause the gallbladder to eject, flush stones which is another risk I wouldn’t want to take. I was on a forum site reading about doing the “liver flush” to get rid of gallstones and this one gal had a pancreatitis attack. After she healed she did it again! Some folks don’t learn well lol – Yet – I have people who come to this site who do liver flushes and swear by them. I just can’t recommend them in good conscience. I’d do the iron rich foods to normalize the bile. The iron thing may take longer but it is so much safer. I hope you have a happy, blessed new year 🙂
Thank you very much for your thoughtful response
You are very welcome Carol 🙂
Can you tell me more about the interaction of iron and pancreatitis? I always present as anemic when pregnant and also have the most problems with my pancreas then. I have had dozens of acute pancreatitis attacks in my life – but more constant tenderness when pregnant and less frequent full blown attacks. I actually was worried my acute pancreatitis was turning into CP.
Christine the only thing I know about iron in relation to pancreatitis is that people who are low on iron (especially women) seem to be more prone to develop gallstones which of course can and do cause acute pancreatitis.
I know the pancreas produces different enzymes for carbs, protein and fat. Did you find any support as to why fat is more inflammatory and damaging than carbs or protein? Why lipase is more problematic than other enzymes? It’s confusing, especially as you recognized above omega 3 fats are anti inflammatory. Living a low fat diet has so many consequences- low energy and higher risk for Alzheimer’s (I read somewhere), low fat increases insulin reaction, fat soluble vitamins etc. It’s also really unhealthy for a developing baby. Since reading your blog I have definitely cut down on fat (a lot!) but no fat has risks and challenges especially pregnant. And currently really low fat but I van too sustain it. I also can’t really fast like I normally would. I am not really sure what is going on now- I am about 4 weeks of daily pain / deep heart burn (some days good, some bad) – it isn’t horrible but not pain free. I can maintain daily life- work etc but worrisome. According to my blood work my amalyse and lipase aren’t raised currently but could have been weeks ago if I did have a AP attack- but I didn’t normal intense pain or some marking moment only a dull pain. I had ultrasound on my gallbladder but waiting on results. I have never been diagnosed with CP but totally possible either now and likely in future given that I have hade reoccurring AP in the past and hereditary pancreatitis. I have only had 1 AP attack in 5 years that was painful but only about 36 hours that alleviate with liquid / cracker diet- also while pregnant. I know it gets inflamed here and there but not a really painful AP. I had thought I as managing it well since I didn’t have AP and thought I was doing well with limited pain. I didn’t realize that’s is was still being damaged AND could be avoided. In that regard this blog is particular earth shattering info! However, I was eating a very high fat diet- compared to this blog and most people. Whole milk, full fat cheese and yogurt, almonds, avocado etc. not junk foods but not low fat , I am a healthy weight (slim 120lbs) but now I know not the best diet for hereditarily pancreatitis. I didn’t really eat large meals etc My last question is, do you know if there is anything you can eat with fat to help your body digest it more easily? Historically (until past 4 weeks and I can’t do the food diary/ fasting until post baby to figure out the real triggers) I have tolerated a lot of fat as described- so I wonder what else I could in the future to balance the risks of low fat while pregnant and pancreatitis? (Assuming this pain is cleared up) I clearly won’t eat pork or chips or processes or fried foods, no alcohol etc. papaya or grapefruit or anything like that?
I mean right during this period – I have been eating fruits, vegetables and juices but not pain free. It may or may not be CP but just seems such the obvious culprit given my history. Anyway, long winded answer or asking if you know why lipase is more problematic and what can be done to assist in fat digestion.
Hi Christine – Let me answer your questions as best I can.
Question #1: “Did you find any support as to why fat is more inflammatory and damaging than carbs or protein?”
Answer: No. The only research I looked for and found was concerning the inflammatory nature of fat which was posted under references. Too much protein can also cause some issues in some folks but most do well with protein.
Question #2: “Why lipase is more problematic than other enzymes?”
Answer: Lipase breaks down fat. That is it’s main purpose. I don’t know if lipase is more problematic. If it is it is possibly due to fat consumption. A normal human diet is full of fat, some more than others.
Question #3: “My last question is, do you know if there is anything you can eat with fat to help your body digest it more easily?”
Answer: Pancreatic enzymes containing lipase. You can get low dose enzyme formulas OTC (over-the-counter) BUT ask your doctor first.
Fruits and vegetables are not you problem. Very few contain fat and the ones that do (e.g. soy, coconut, avocado) should be avoided or taken in very small portions under normal circumstances (e.g. not pregnant).
I can understand your situation (pregnancy). The baby comes first. You have special needs at this time which may or may not be addressed properly via an extremely low fat diet. In your situation it may be much more prudent to visit with your doctor and heed his/her advice. I do know that if you are eating high fat and/or trigger foods (e.g. red meat, nuts, whole milk, cheese, etc) until you deliver you will most likely have pain and an increased risk of AP due to inflammation (caused by fat consumption) and fat consumption itself. Catch 22.
Thank you so much! I didn’t see this before I posted again below. My prenatal vitamin actually has lipase in it but was thinking it maybe was an irritant because I started it same time around pain/ as tamiflu. This is the longest I’ve had a problem…
Hi Christine – No worries – you’re welcome. I doubt the lipase is the problem. I’d suspect the Tamiflu. That stuff can make people sicker than the flu lol.
Oh I think I found some info on why lipase is worse- Pancreatic juice plays a key role in the digestion of all macronutrients, but is most crucial for lipid digestion. Protein digestion begins in the stomach with the concomitant action of hydrochloric acid and pepsin, continues with pancreatic proteases in the duodenum, and finishes with numerous brush border peptidases located all over the small intestine.50 Starch digestion begins in the mouth with salivary amylase, continues with pancreatic amylase, and ends with several intestinal brush border oligosaccharidases.50 In contrast, the majority of lipid digestion and absorption occurs between the pylorus and the ligament of Treitz. article goes on to say mostly in pancreas.
Also, have to read anything about role of sodium bicarbonate?
I am curious if you have read anything about MCT oil? I have seen some information that it does not trigger the pancreas to release enzymes. What are your thoughts on MCT oil (not coconut oil)?
Hi Katie – yes I have read about MCT oil. I have never tried it. I don’t trust what is said but that doesn’t mean it is unsafe. I just can’t believe oil, which is always pure fat of some kind, would be safe. Let me know how it works out for you if you try it.
The first video you showed mentions the two most common reasons for pancreatitis.
“Gallstones and alcohol.” What caused the problems in the gallbladder and liver?
Why do kids and adults that don’t drink get diagnosed with a fatty liver? NAFLD. It’s non alcoholic fattly liver disease. Fat didn’t cause it.
A cheeseburger didn’t cause it. Eating grain and fake cheese and fruit juice and soda did.
Fat was never the problem. A no fat diet never made sense and it doesn’t now.
I don’t agree with all your conclusions.
But no fat? Ever? If you don’t know how MCT works… and that comment was in 2020, what else are you ignorant of?
Functional medicine
Gut Dysbiosis
Leaky Gut
Leaky Brain
Autoimmune diseases
Mitochondrial Dysfunction
Inflammation
Probiotics/Prebiotics
Stomach PH
Ancel Keys?
Alopathic medicine?
…no.
SugarIsTheEnemy – I am not going to ask you why you are so stupid that you seem unable to read and comprehend that fat is fine unless your pancreas is DAMAGED by inflammation due to acute and/or chronic pancreatitis. I mean seriously how stupid can you be yet still breathe? You gotta be a doctor, nurse or dietitian. Have a nice day somewhere else. 🙂
I love this, Paul. You must be spot on. Lol
Definitely what I need right now. My friend is now having trouble and I want to do something for him but I have no money to help. Maybe your valuable piece of knowledge will probably be of help.
Is Coffee ok in small amounts?
Pancreatitis in 8/19, had J and G tubes installed. I was good for about 2 years but now everything bothers me it seems so im learning. Have a cyst that docs wont remove because its hardened.
So i like to drink organic coffee in morning about 8 oz?
Steven I drink coffee without issue. It’s full of polyphenols which are highly anti-inflammatory. Some people say they do not tolerate it but they may be eating or drinking something else that is the real culprit; Then, maybe not.