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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Nausea After Whipple Procedure?

Brother-in-law is 15 days post-op Whipple procedure - took over 10 hours: known adenoca of pancreas, no additional pathology back yet: prescribed Nexium and Maxeran (for nausea and 1 bout emesis when first starting back on soft food). Home from hospital (at 12 days post-op with minor nausea on & off - no emesis). Sister is adamant he eat and call Dr. to advise he s still feeling some nausea - I (the sister-in-law) have tried to explain he needs to take it slow, small sips, small bits of fluids/soft food (cream soup/puddings - high in calories) 5-6 little meals in a day, but that if he doesn t feel like eating don t force the issue. Tried to explain the number of places incised in procedure, number of places sutured up, the potential for inflammation/swelling of tissue and time it takes for all to heal and return to as normal a state as possible, as well as potential for altered processing of food with compromised stomach, removal of gallbladder, portion of pancreas and new connection to small intestine. My sister seems to think that as he s home everything should follow a set time frame; I disagree and say medicine is not a perfect/fine science , all patients are different in recovery and physicians only can provide info based on previous patients outcome time frames...which are not the same for everyone. I am of the mind, he s eating slowly, not spiking a temp, incision does not seem to be overly tender, hot or red and he is ambulating and doing day-to-day activities, but needing a lot of sleep is normal and what we should be aiming for. The diet, from clear fluid, to soft foods and so on back to a normal diet will take time and shouldn t be rushed - he should only eat and drink as much as he feels comfortable to do so.
Fri, 1 Dec 2017
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General Surgeon 's  Response
Hello,
It is quite early in his post operative recovery and the whipple procedure is a major operation. Normal appetite may take some time to recover. Diet should be introduced slowly, but there does need to be an effort for adequate caloric intake as his body requires the energy to recover from the procedure and heal from the cancer. if he has a feeding tube more distal to his surgical reanastamosis, consider tube feedings and then he can have pleasure oral intake. If he does not have a feeding tube, consider higher caloric liquids such as ensures, boost, nutritional shakes that provide more calorie per milliliter of liquid. it may take weeks to months for body to feel "normal" after surgical procedures as extensive as a whipple. hope this helps.
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What Causes Nausea After Whipple Procedure?

Hello, It is quite early in his post operative recovery and the whipple procedure is a major operation. Normal appetite may take some time to recover. Diet should be introduced slowly, but there does need to be an effort for adequate caloric intake as his body requires the energy to recover from the procedure and heal from the cancer. if he has a feeding tube more distal to his surgical reanastamosis, consider tube feedings and then he can have pleasure oral intake. If he does not have a feeding tube, consider higher caloric liquids such as ensures, boost, nutritional shakes that provide more calorie per milliliter of liquid. it may take weeks to months for body to feel normal after surgical procedures as extensive as a whipple. hope this helps.