Diet problems caused by bile duct cancer
You might need to change what and when you eat if you have bile duct cancer or have had surgery to remove it. You might also need to take supplements to increase the number of 
you have, or to help you digest food.
You normally see a dietitian who will explain these changes and support you to make them.
Eating when you have bile duct cancer
Bile duct cancer can make you feel sick (nausea) and lose your appetite. This can make you lose weight. And if you have jaundice, it can be difficult for your body to take in fat from your diet.
There are things you can try to help you keep eating. These include having snacks and small meals or using nutritional supplements.
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 calories you eat. You might need to have nutritional supplements to help with this. Your dietitian will give advice on what to use and what you can get on prescription.
Some ways you can use supplements include:
- sprinkling protein powders or high energy powders onto everyday foods. You can also add them to recipes
- having complete meals in a drink - Ensure and Fresubin are well known makes. You get these on prescription from your doctor or buy them from a chemist. Some of these come in cartons about the size of a small fruit juice
- sipping a supplement between meals throughout the day - this can really boost your calorie intake
Diet problems after surgery to remove bile duct cancer
If you have distal bile duct cancer, your surgeon might remove your gallbladder, part of your small bowel and part of your pancreas. This can cause side effects including:
- loose or watery poo (diarrhoea)
- difficulty digesting food
diabetes if your surgeon had to remove a large part of your pancreas
You may also have nausea or feel full quickly. Tell your surgeon or specialist nurse about any digestive problems you have. They can give you treatment to control them. But it can take time to get things right.
Managing diarrhoea
Tell your healthcare team if you have diarrhoea. They may give you medicine 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, although this may not be possible. Depending on your situation, your team might suggest you cut back on very high fibre foods such as dried fruit and beans.
You should also drink plenty to try and replace the fluid lost. Aim for 8 to 10 glasses per day.
Difficulty digesting food
Your pancreas makes digestive juices. This helps you digest your food.
You might not make enough digestive juices if you have bile duct cancer or if you had part of your pancreas removed. If this happens, you usually take an supplement. This helps you digest fat, protein and the sugar in food. The supplements usually come as capsules that you swallow.
Diabetes
Your pancreas also makes insulin. This is a that controls the amount of sugar in your blood. If you have diabetes your pancreas doesn’t make enough insulin.
If you had part of your pancreas removed, you will probably still make enough insulin. But your healthcare team will keep a very close eye on your blood sugar to make sure you don't develop diabetes.
Diet problems caused by other cancer treatments
Other treatments for bile duct cancer can cause problems with eating, drinking and digestion.
Chemotherapy, immunotherapy and targeted cancer drugs are all treatments for bile duct cancer. These can make some people feel sick and lose their appetite. Chemotherapy can also make your mouth very sore, making it painful to eat.
Speak to your health care team if you are having side effects from the treatment you are having. Doctors can manage most side effects, and there are things you can do to help you cope.
