Background

• Pancreatitis since 5 years, chronic for 3 years (age 18 now).
• Fecal elastase: 29 (severe exocrine insufficiency).
• Had a stent placed earlier; removed 10 days ago.
• Attack occurred 4 days after removal .
• Currently on PERT (pancreatic enzymes).
• Consulted top gastroenterologist (world-class hospital) and also a senior Ayurvedic doctor.
• Doctor’s advice: live normally, prepare for competitive exams, avoid spicy/fatty food. I can control food, but attacks still happen randomly.

Current issues

• Constipation after attacks.
• Need to gain weight.
• Worried about stress, sleep, exercise, and future endocrine problems.

My questions

1. Can I increase my fecal elastase? Can my remaining pancreas heal over time? If yes, how?
2. Diet for weight gain + protein: Can I take soya chunks with PERT? They have only ~0.5g fat per serving.
3. Will I need PERT forever? Can I ever eat any meal without it?
4. Attacks despite perfect diet: Can attacks still happen even when I strictly avoid triggers?
5. Stress: Does mental stress (even “healthy” stress like studying) trigger attacks?
6. Sleep & exam prep: I need to stay up late for competitive exam preparation. Does disturbed or insufficient sleep affect pancreatitis?
7. Post-attack constipation: After an attack, I get severe constipation for 4–5 days, terrible flatulence, and laxatives don’t work. What should I do?
8. Weight gain – practical tips for someone on low-fat, PERT-dependent diet?
9. Foods without PERT: Which foods can I safely eat without taking enzymes?
10. Low-fat veggie snacks: If I eat raw/low-fat vegetables as a snack, will my damaged pancreas still digest the nutrients?
11. Endocrine risk: I currently have no diabetes (I don’t like sugar/sweets anyway). But what is my future risk of becoming diabetic?
12. Physical jerking: Can heavy jerking while riding a bike on a rough road cause a flare-up?
13. Exercise & weight lifting:

• How much weight can I safely lift?
• Which yoga/exercises/meditation are allowed, especially those involving abdominal engagement

14. any other precautions you might suggest ? . Thank you