Q: I was diagnosed with pancreatitis last year. I was treated to reduce my swollen pancreas and was operated to remove the gall bladder at the same time. However, after the operation, I can't get rid of swollen feet. Doctors told me to take protein tablets. I am a vegetarian. Its been 8 months but the swelling in my feet hasn't gone. What should I do? My feet feel heavy and numb. What should I eat and what medicines should I take?

A:The swelling in the feet can have many causes even if it has occurred as a result of Pancreatitis. The one is what doctors have diagnosed that is Hypoproteinaemia (Low blood protein) this is result of the severe loss of the body protein during the illness of Pancreatitis or any severe illness, combined to this is the poor intake and inadequate digestive power due to the disease. If this is the case then taking high protein diet is good enough and in time it should settle down. It is unusual for the recovery in the low protein state to take this length of time. This makes it necessary that further investigations should be done along with the establishing the accuracy of the diagnosis of low protein state. The other causes, which may be responsible are venous thrombosis of legs, which has occurred during the illness and is now causing residual swelling. This can be diagnosed by doing the echo-doppler and then appropriate treatment can be introduced. The other cause is kidney failure, which can be a complication of the severe illness from acute pancreatitis. This may not have fully recovered and needs to be investigated. It is possible now a days to quantify the degree of the recovery of the kidney. A further advice from the Nephrologist is needed if this is the case. Occasionally there may be border line damage to the kidneys due to blood pressure or diabetes, which is made worse by the Pancreatitis. Other cause could be that there is heart disease and this is keeping the swelling going. This diagnosis can be established by investigating the status of the heart and treated by a cardiologist or a physician. Sometimes it is the combination of the different illnesses that are to blame. If at the end of the day all other investigations are satisfactory and the diagnosis is low protein state and you being a vegetarian cannot take animal products then an advice from a dietician is going to be helpful. There are various sources in the vegetables and diary products that are rich source of protein.