The oral refeeding trilemma of acute pancreatitis: what, when and who?
Tolerance of oral refeeding is an essential goal of nutritional management of acute pancreatitis. However, oral feeding intolerance remains one of the most common complications in patients with this disease. It often results in longer periods of hospitalization, increased treatment costs, increased risk of readmission, and reduced quality of life. The traditional practice involves keeping patients nil by mouth followed by gradual stepwise reintroduction of food. However, it does not have a solid evidence base and, hence, there is increasing interest in determining alternative strategies that may be beneficial in reducing the occurrence of oral feeding intolerance. This review focuses on the randomized controlled trials that investigated the key questions informing the nutritional management of acute pancreatitis: when to feed, what to feed and who is in charge of the decision-making.
a Department of Surgery, University of Auckland, Auckland, New Zealand.
Melody G
MG
Bevan
a Department of Surgery, University of Auckland, Auckland, New Zealand.
Varsha
V
Asrani
Maxim S
MS
Petrov
D000208:Acute Disease; D003289:Convalescence; D004032:Diet / Q000009:adverse effects*; D004435:Eating; D004750:Enteral Nutrition / Q000009:adverse effects*; D006801:Humans; D009747:Nutritional Physiological Phenomena; D010195:Pancreatitis / Q000503:physiopathology / Q000628:therapy*; D010348:Patient Care Team; D012008:Recurrence; D013997:Time Factors
acute pancreatitis; gut rousing; nutritional management; oral feeding intolerance; oral refeeding; patient-centered care