The Best Diet for Bile Duct Cancer: What to Eat to Get the Nutrition You Need

Bile duct cancer starts in the tubes that carry bile — the fluid that helps your body digest foods — between your liver, gallbladder, and small intestine. While you're going through treatment for bile duct cancer, eating the right balance of foods is important for keeping up your weight and strength, according to the National Cancer Institute.

Yet sticking to a healthy diet is easier said than done when you have a cancer that affects your digestive tract. It's common for people with bile duct cancer to lose their appetite and shed weight. "A patient's appetite can be impacted by not only the bile duct cancer itself, but also by the side effects of the treatments associated with bile duct cancer," says Hannah Santoro, a clinical dietitian at Roswell Park Comprehensive Cancer Center in Buffalo, New York.

Bile duct cancer and its treatments can cause symptoms like nausea, vomiting, and belly pain that destroy your interest in eating — or make anything you do eat come right back up. But getting the right nutrition is essential for managing your cancer. Below, two cancer dietitians share their best tips for eating well with bile duct cancer — even when you don't have an appetite.

How Might Bile Duct Cancer Affect Nutrition?

If you’ve had surgery to remove your gallbladder or part of your small intestine, liver, and pancreas, the loss of these organs can leave you with symptoms like nausea and diarrhea. These symptoms not only make it harder to eat, but also to digest and absorb the nutrients from food, according to Cancer Research UK.

Losing your appetite after surgery creates a "perfect storm," says Tracy Crane, PhD, RDN, co-leader of the Cancer Control Research Program and associate professor of medicine in the division of medical oncology at Sylvester Comprehensive Cancer Center in Miami. "Surgery causes all kinds of stress on the body, and it takes a lot of nutrients to heal properly," she says. "When you're trying to heal, the weight loss becomes a substantial issue."

When you don't get enough nutrients from food, your body turns to alternative energy sources like fat stores and lean muscle mass for fuel. Eventually you'll lose energy, and possibly even become malnourished, says Santoro.

What’s the Best Diet for Bile Duct Cancer?

Focus on nutrient density. Eating a well-balanced diet with plenty of protein, healthy fat, and calories will help you keep weight on while getting enough nutrients in. "We recommend nutrient-dense foods such as fruits, vegetables, whole grains, and lean protein such as Greek yogurt, cottage cheese, beans, legumes, turkey, chicken, and eggs, which all help to maintain weight," Santoro says.

If you can't get enough calories from your current diet, consider adding more calorically dense foods, like peanut or almond butter to your meals. Or sprinkle nonfat dry milk or protein powder into oatmeal or soup. "You never notice it's there and it adds quite a bit of protein for not much volume," says Dr. Crane.

Ask about enzymes. Some people with bile duct cancer develop jaundice — a yellowing of the skin and eyes that happens when your liver can't break down the waste product bilirubin. Having jaundice could make it harder for your body to absorb fat from food. Ask your doctor about taking enzymes before meals to help with digestion, Crane suggests.

Get hydrated. Fluids are important, too. Drink plenty of water throughout the day to stay well-hydrated. A sports drink will add back the electrolytes you lose from vomiting and diarrhea. If nausea is an issue, try a carbonated drink like sparkling water, says Crane. Avoid sodas, both because of the sugar and the caffeine, which is a diuretic that strips your body of even more fluid.

How Diet Can Help Relieve Symptoms

Eating might be the last thing on your mind when you’re dealing with nausea and diarrhea, but some foods help with these symptoms. “Things like ginger can be helpful for nausea,” says Crane. A combination of salty and sweet — like lemonade with a pretzel or crackers — may also be easier to keep down, she says.

Bland and easy-to-digest foods can work in conjunction with anti-nausea and anti-diarrheal medicines to manage these symptoms. Try low-fiber grains like white rice, bread, and cereal; fruits such as bananas and melons; and cooked vegetables. Removing the seeds and peels of fruits and vegetables will help with digestion. You might also puree your fruits and vegetables into a smoothie to make them go down easier, suggests Crane.

Instead of eating three big meals, break them up into several small ones spread throughout the day. Smaller portions may be easier for you to tolerate and digest.

Foods to Avoid With Bile Duct Cancer

Try to limit or cut out foods that don't give you any nutrition for the calories — things like fried foods, processed meats such as bacon and hot dogs, and sweets like cookies and cake. "These foods are typically more difficult for a patient with bile duct cancer to digest, and may cause symptoms of [gastrointestinal] distress, such as diarrhea, constipation, nausea, and vomiting," says Santoro.

Cancer and treatments like chemotherapy can weaken your immune system. Avoid deli meats and raw or undercooked foods (like sushi). Thoroughly wash your produce and cook meat, poultry, and fish all the way through to avoid exposure to bacteria and other germs.

Eating During Treatment for Bile Duct Cancer

Try to get the bulk of your nutrients from food — not pills. "We always recommend that people avoid supplements while they're undergoing treatment, unless their physician or healthcare team prescribes them," Crane says. "They could interact with the treatment medications."

If you have any questions about your diet, a dietitian is the one to ask. Most cancer centers have at least one on staff, and they can guide you through the best way to eat during your treatment.