Nutrition and Enzymes

Pancreatic Enzyme Replacement Therapy (PERT)

Many people with pancreatic cancer develop Pancreatic Exocrine Insufficiency (PEI), meaning their pancreas no longer produces enough enzymes to digest food properly. This can lead to bloating, diarrhea, oily stools, weight loss, and poor nutrient absorption.

PERT replaces these enzymes, helping you digest food, absorb nutrients, and improve your overall quality of life.

Take PERT with every meal and snack that contains fat, protein, or carbs. It works best when taken during a meal or just before eating.

Finding the Right Dose

The right PERT dose depends on:

• Your meal size and fat content
• Your weight and symptoms
• Whether it’s a meal or a snack

Use our PERT Calculator to estimate how many enzyme capsules to take.

This is just a guideline, your healthcare team can help adjust your dose as needed.

Helpful Tips:

• Swallow capsules whole with water (don’t chew)
• Store in a cool, dry place
• Some capsules can be opened on soft, acidic foods if swallowing is hard (ask your doctor)

If symptoms continue, talk to your care team about dose or timing

Why it matters:

Without PERT, even a balanced diet won’t be fully absorbed. The right enzyme support helps maintain weight, energy, and well-being.

Key Symptoms of PEI

• Greasy, floating stools
• Bloating, gas, and cramping
• Unintended weight loss
• Fatigue and weakness
• Poor appetite
• Diarrhea or frequent bathroom visits

Nutrition Guidelines

• Eat 6–8 small meals per day
• Chew slowly
• Stay hydrated (6–8 cups of water daily)
• Limit fatty foods (processed, fried, or rich foods)
• Use healthy fats (nuts, seeds, olives, fatty fish)
• Reduce fiber (limit whole grains and raw veggies)
• Avoid gassy foods (onions, cabbage, corn, soda, gum)
• Choose high-calorie foods (to maintain weight and energy)
• Take vitamin supplements (as prescribed: A, D, E, K)
• Avoid alcohol, drugs, and smoking
• Be physically active, if possible