Nutritional management of acute pancreatitis.
Most patients with acute pancreatitis have mild to moderate disease and require no specialized nutritional support. Twenty percent to 30% have severe cases, resulting in a catabolic hypermetabolic state, and these patients may require early aggressive nutritional support. Traditionally, this support has been in the form of total parenteral nutrition. However, recent data suggest that enteral nutrition infused into the jejunum is feasible, well tolerated, associated with fewer complications, and significantly less expensive than parenteral nutrition. The pathophysiology of gut function in acute pancreatitis and the rationale and evidence for parenteral and enteral nutritional support are reviewed herein. An algorithm on the nutritional management of acute pancreatitis is suggested.
Fang
John
J
Department of Gastroenterology, University of Utah Health Sciences Center, 30 North 1900 East, Room 4R118, Salt Lake City, UT 84132, USA.
DiSario
James A
JA
D000208:Acute Disease; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods; D006801:Humans; D010179:Pancreas / Q000378:metabolism / Q000502:physiology; D010195:Pancreatitis / Q000503:physiopathology / Q000628:therapy*; D010289:Parenteral Nutrition, Total / Q000009:adverse effects / Q000379:methods; D012720:Severity of Illness Index