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Nutrition and Acute Pancreatitis

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Nutrition and Gastrointestinal Disease

Part of the book series: Clinical Gastroenterology ((CG))

Summary

Acute pancreatitis is a disease of variable severity and outcome: mild disease may be treated at home, while severe disease often leads to several weeks in the ICU with mortality rates approaching 50%. Cell and molecular biological studies have increased our knowledge of the pathophysiology of the disease dramatically over the past decade, but have not, as yet, led to a specific treatment. All of the improvement in outcome can be attributed to supportive measures, such as nutrition. Clinical investigations have shown that acute pancreatitis is a highly catabolic illness, and protein deficiency could occur before the 2nd week of illness if no feeding is given. Parenteral nutrition (PN) is effective in preventing protein catabolism, and also ‘rests’ the pancreas, but increases the already high risk of septic and metabolic side-effects, and worsens outcome in mild illness. Enteral feeding is superior to PN in the management of acute pancreatitis, even if it is polymeric or infused directly into the stomach. Unfortunately, however, enteral feeding stimulates pancreatic trypsin production and may exacerbate the disease process unless delivered well down the jejunum. The most likely reason for the superiority of enteral over parenteral feeding is its capacity to maintain intestinal function and suppress the cytokine-mediated systemic inflammatory response and consequent multiple organ failure.

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O’Keefe, S.J.D. (2008). Nutrition and Acute Pancreatitis. In: Nutrition and Gastrointestinal Disease. Clinical Gastroenterology. Humana Press. https://doi.org/10.1007/978-1-59745-320-2_5

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  • DOI: https://doi.org/10.1007/978-1-59745-320-2_5

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-808-9

  • Online ISBN: 978-1-59745-320-2

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