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Nutrition support in acute pancreatitis.
JOP. 2008 Jul 10; 9(4):375-90.JOP

Abstract

In the majority (80%) of patients with acute pancreatitis, the disease is self limiting and, after a few days of withholding feeding and intravenous administration of fluids, patients can again be normally fed orally. In a small percentage of patients, the disease progresses to severe necrotic pancreatitis, with an intense systemic inflammatory response and often with multiple organ dysfunction syndrome. As mortality is high in patients with severe disease and as mortality and morbidity rates are directly related to the failure of establishing a positive nitrogen balance, it is assumed that feeding will improve survival in patients with severe disease. The aim of nutritional support is to cover the elevated metabolic demands as much as possible, without stimulating pancreatic secretion and maximizing self-digestion. The administration of either total parenteral nutrition or jejunal nutrition does not stimulate pancreatic secretion. Recently, a series of controlled clinical studies has been conducted in order to evaluate the effectiveness of enteral nutrition with jejunal administration of the nutritional solution. The results have shown that enteral nutrition, as compared to total parenteral nutrition, was cheaper, safer and more effective as regards the suppression of the immunoinflammatory response, the decrease of septic complications, the need for surgery for the management of the complications of acute pancreatitis and the reduction of the total hospitalization period. It did not seem to affect mortality or the rate of non-septic complications. In conclusion, enteral nutrition should be the preferred route of nutritional support in patients with acute pancreatitis.

Authors+Show Affiliations

Fourth Surgical Department, Medical School, Aristotle University, Thessaloniki, Greece. telonakos@yahoo.grNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

18648127

Citation

Ioannidis, Orestis, et al. "Nutrition Support in Acute Pancreatitis." JOP : Journal of the Pancreas, vol. 9, no. 4, 2008, pp. 375-90.
Ioannidis O, Lavrentieva A, Botsios D. Nutrition support in acute pancreatitis. JOP. 2008;9(4):375-90.
Ioannidis, O., Lavrentieva, A., & Botsios, D. (2008). Nutrition support in acute pancreatitis. JOP : Journal of the Pancreas, 9(4), 375-90.
Ioannidis O, Lavrentieva A, Botsios D. Nutrition Support in Acute Pancreatitis. JOP. 2008 Jul 10;9(4):375-90. PubMed PMID: 18648127.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nutrition support in acute pancreatitis. AU - Ioannidis,Orestis, AU - Lavrentieva,Athina, AU - Botsios,Dimitrios, Y1 - 2008/07/10/ PY - 2008/7/24/pubmed PY - 2008/8/20/medline PY - 2008/7/24/entrez SP - 375 EP - 90 JF - JOP : Journal of the pancreas JO - JOP VL - 9 IS - 4 N2 - In the majority (80%) of patients with acute pancreatitis, the disease is self limiting and, after a few days of withholding feeding and intravenous administration of fluids, patients can again be normally fed orally. In a small percentage of patients, the disease progresses to severe necrotic pancreatitis, with an intense systemic inflammatory response and often with multiple organ dysfunction syndrome. As mortality is high in patients with severe disease and as mortality and morbidity rates are directly related to the failure of establishing a positive nitrogen balance, it is assumed that feeding will improve survival in patients with severe disease. The aim of nutritional support is to cover the elevated metabolic demands as much as possible, without stimulating pancreatic secretion and maximizing self-digestion. The administration of either total parenteral nutrition or jejunal nutrition does not stimulate pancreatic secretion. Recently, a series of controlled clinical studies has been conducted in order to evaluate the effectiveness of enteral nutrition with jejunal administration of the nutritional solution. The results have shown that enteral nutrition, as compared to total parenteral nutrition, was cheaper, safer and more effective as regards the suppression of the immunoinflammatory response, the decrease of septic complications, the need for surgery for the management of the complications of acute pancreatitis and the reduction of the total hospitalization period. It did not seem to affect mortality or the rate of non-septic complications. In conclusion, enteral nutrition should be the preferred route of nutritional support in patients with acute pancreatitis. SN - 1590-8577 UR - https://www.unboundmedicine.com/medline/citation/18648127/Nutrition_support_in_acute_pancreatitis_ DB - PRIME DP - Unbound Medicine ER -