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[Nutrition in acute pancreatitis].
Z Gastroenterol. 2008 Aug; 46(8):784-9.ZG

Abstract

Nutritional concepts in acute pancreatitis are undergoing a rapid change. An early start of nutrition via nasojejunal tubes is about to replace parenteral nutrition. Yesterday it was believed that the pancreas had to be put at rest. Thus, stimulation of pancreatic secretion by enteral nutrition was believed to be detrimental. However, on comparing the results of enteral with those of parenteral nutrition, the pancreatic infection rates, rate of surgical interventions, days of hospital stay, and costs are found to be significantly reduced. Whether or not enteral nutrition decreases mortality has not been clearly proven. Pancreatitis is associated with the risk of paralytic ileus. Thus, data suggesting that one does not have to feed via a nasojejunal tube but rather via an easier to place nasogastric tube, are provocative. Numerous questions still have to be answered such as composition of tube diet, nutrition in mild to moderate pancreatitis, ways to reduce pain and composition of diet when oral refeeding is started. The nutrition of tomorrow may implicate immunonutrition. There are only a few small studies suggesting beneficial effects by supplementation of tube feeding with MCT/LCT triglycerides, glutamine, arginin, omega-3-fatty acids, nucleotides. So far, these supplements have failed to show efficacy for clinically relevant endpoints. In an recently published study, prebiotics were associated with a high complication rate. In this review, we summarise the current knowledge on nutrition in acute pancreatitis and discuss future developments.

Authors+Show Affiliations

Medizinische Klinik und Poliklinik II, Universitätsklinikum Leipzig.No affiliation info available

Pub Type(s)

English Abstract
Journal Article
Review

Language

ger

PubMed ID

18759203

Citation

Mössner, J, and N Teich. "[Nutrition in Acute Pancreatitis]." Zeitschrift Fur Gastroenterologie, vol. 46, no. 8, 2008, pp. 784-9.
Mössner J, Teich N. [Nutrition in acute pancreatitis]. Z Gastroenterol. 2008;46(8):784-9.
Mössner, J., & Teich, N. (2008). [Nutrition in acute pancreatitis]. Zeitschrift Fur Gastroenterologie, 46(8), 784-9. https://doi.org/10.1055/s-2008-1027462
Mössner J, Teich N. [Nutrition in Acute Pancreatitis]. Z Gastroenterol. 2008;46(8):784-9. PubMed PMID: 18759203.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Nutrition in acute pancreatitis]. AU - Mössner,J, AU - Teich,N, PY - 2008/9/2/pubmed PY - 2008/11/19/medline PY - 2008/9/2/entrez SP - 784 EP - 9 JF - Zeitschrift fur Gastroenterologie JO - Z Gastroenterol VL - 46 IS - 8 N2 - Nutritional concepts in acute pancreatitis are undergoing a rapid change. An early start of nutrition via nasojejunal tubes is about to replace parenteral nutrition. Yesterday it was believed that the pancreas had to be put at rest. Thus, stimulation of pancreatic secretion by enteral nutrition was believed to be detrimental. However, on comparing the results of enteral with those of parenteral nutrition, the pancreatic infection rates, rate of surgical interventions, days of hospital stay, and costs are found to be significantly reduced. Whether or not enteral nutrition decreases mortality has not been clearly proven. Pancreatitis is associated with the risk of paralytic ileus. Thus, data suggesting that one does not have to feed via a nasojejunal tube but rather via an easier to place nasogastric tube, are provocative. Numerous questions still have to be answered such as composition of tube diet, nutrition in mild to moderate pancreatitis, ways to reduce pain and composition of diet when oral refeeding is started. The nutrition of tomorrow may implicate immunonutrition. There are only a few small studies suggesting beneficial effects by supplementation of tube feeding with MCT/LCT triglycerides, glutamine, arginin, omega-3-fatty acids, nucleotides. So far, these supplements have failed to show efficacy for clinically relevant endpoints. In an recently published study, prebiotics were associated with a high complication rate. In this review, we summarise the current knowledge on nutrition in acute pancreatitis and discuss future developments. SN - 0044-2771 UR - https://www.unboundmedicine.com/medline/citation/18759203/[Nutrition_in_acute_pancreatitis]_ DB - PRIME DP - Unbound Medicine ER -