Nutrition Malnutrition is a common problem because of loss of appetite, diarrhea, poor fat absorption and the loss of bile salts because of bile drainage diversions or bile duct obstruction. Fat-soluble vitamin deficiencies (A, D, E, K) may also occur.
• Frequent feedings, use of digestive replacement enzymes (pancreatin, pancrelipase) and antinausea drugs will
be needed.
• Low-fat food or supplements (medium-chain triglycerides) may help provide proteins and calories.
• Gastric and jejunal tube feeding or intravenous hyperalimentation can help reduce malnutrition.
Pain Control This often becomes a major problem, but morphine or narcotics can help. If these are not effective, celiac nerve blocks or the infusion of morphine by vein or the spinal canal can help control pain in a majority of patients.
