Coping with diet problems caused by bile duct cancer
Many people who have bile duct cancer lose their appetite and some may lose weight. If you have 
it can be difficult for your body to take in fat from your diet. You might need to take supplements to boost your calorie intake, and you may need to avoid fatty food until you have had treatment to relieve the jaundice.
You may also have problems with your diet if you have had surgery to try to cure bile duct cancer.
Surgery to try to cure bile duct cancer often involves removing the gallbladder, part of the bowel, liver and pancreas. Any problems you might have after surgery will depend on the type of surgery you had. Problems include:
- loose or watery poo (diarrhoea)
- nausea
- difficulty digesting food
diabetes if doctors remove a large part of your pancreas
Tell your doctor or specialist nurse about any digestive problems you have. They can give you treatment to control them. Sometimes, it takes time to get things right.
Snacks and small meals
You may find it easier to have lots of small meals through the day, rather than sticking to the traditional 3 meals a day.
It is a good idea to have plenty of nutritious snacks to hand that you can have whenever you feel like eating. If you can manage it, it's best to choose full fat versions of yoghurts and puddings, so that you get the most calories.
You could try:
- yoghurts or fromage frais
- other soft puddings such as trifle or chocolate mousse
- dried fruit
- stewed or fresh fruit (bananas are high in calories)
- nuts
- cheese
- instant soups (make up with milk to boost calories)
- cereal
- milky drinks
- flapjacks
Some of these ideas may not suit your digestion but they might be worth a try. If in doubt, check with your dietitian.
Try to think of quick ways of having the things you like to eat. If possible, get someone to prepare your favourite foods in advance and freeze them in small portions. A microwave makes defrosting and heating easier and quicker.
Nutritional supplements
If you have lost weight you may need to increase the amount of calories you eat.
You can sprinkle protein powders or high energy powders onto everyday foods or add them to recipes. You can also get complete meals in a drink. Ensure and Fresubin are well known makes. You can get these drinks on prescription from your doctor or buy them from chemist shops. Some of these come in 200ml cartons (the size of a small fruit juice carton).
Sipping a supplement between meals throughout the day can really boost your calorie intake. Ask your dietitian for advice on what to use and what you can get on prescription.
Insulin and enzyme supplements
If you had part of your pancreas taken out, you will probably still make enough insulin. Your doctor will need to keep a very close eye on your blood sugar to make sure you don't develop diabetes.
You might not make enough digestive juices if you have bile duct cancer or if you had part of your pancreas taken out. You usually take supplements of enzymes to help you digest fat. These usually come as capsules that you swallow.
Managing diarrhoea
Tell your healthcare team if you have diarrhoea. They may give you some medicines to control your symptoms.
Ask them if you should make any changes to your diet. Generally, it’s best to have a healthy balanced diet if you can. And have small meals and snacks regularly. Depending on your situation, your team might suggest you cut back on very high fibre foods such as dried fruit and beans.
Drink plenty to try and replace the fluid lost. Aim for 8 to 10 glasses per day.
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