“Post Whipple Pain, 11 months and counting?”
My husband underwent a Kausche Whipple 7-17-19 due to 7cm duodenal tumor with high-density displasia cell. He suffered every complication plus kidney failure which slowed his recovery. A week after the surgery, he started suffering from multiple daily horrific intestinal pain incidents. They have reduced to once a day and he can sometimes go a few days without a pain incident. All throughout he described them as someone grabbing and twisting his intestines. Last month, he was hospitalized twice within 11 days (2 nights and 4 nights respectively) for an intestinal obstruction. Now, added to his original pain incidents, is a knife-like stabbing pain, closer to his stomach. We have assiduously followed all dietary suggestions, of which there has been an endless stream of contradictory regimens from Dr, to Dietitian, to Pharmacist. No evidence of new tumors on X-Ray, CT, or PET scan. No one has a clue. 5mg Liquid Oxymorphone, only when he absolutely cannot bear the pain, helps though he avoids it since he loses a day and a half of normal life and hates the drug hangover. He has not been able to gain back the nearly 30 pounds lost and at 5'11" and 137 pounds current weight this is trouble. He is mildly nauseous all the time. Recommendations for supplemental meals say to stay away from fiber, and avoid sunflower oil however, Benecalorie, Ensure, etc, contains it. Benecalorie has high Oleic, Ensure and others just state Sunflower Oil as 3rd or 5th ingredients. Any suggestions?
Male | 81 years old
Complaint duration: 11 months
Medications: enzymes for digestion
Conditions: none save for the post surgical hernias
3 Answers
Consult Functional Medicine. Start Acupuncture with Moxibustion. He has alot of adhesions. Massage abdomen with Woodlock Oil BID to TID. He made need an UGI series.
A very difficult situation and I’m sorry for what you’re going through. If a small bowel series is normal, I’d consider looking into a celiac plexus block. Dissection around these nodes can sometimes cause chronic upper abdominal pain that a block may relieve. It’s hard to say with any certainty but it’s worth looking into.
Sorry to hear you and your husband are suffering so much! Unfortunately, his type of surgery has lots of side effects and "complications" as you have described. There are no quick fixes to resolve the problems and symptoms caused by the changes that were made to his digestive tract from surgery. Some of his symptoms could be due to "dumping syndrome" where the body cannot handle all the food taken in at a meal or there are partial bowel obstruction from the scar formation after surgery. Usual recommendations are to eat frequent small meals and to minimize fatty foods including oils. All foods contain oils and fats, but small amounts are essential for proper nutrition. Recommend starting a daily log of type and amount of foods taken to see if there are any correlation to the symptoms. Start with bland, but balanced diet and introduce foods you might normally eat and see if there are any increase in symptoms. Review the dietary log with your dietician to determine caloric intake as well as nutritious contents of his diet to see what can be optimized. Ask your surgeon if a support group is available for similar patient group, as they will frequently have similar issues that they may have found some solutions to help solve or ease these symptoms.
