[Indications of enteral nutrition in pancreatic disorders]

In the treatment of disorders of the pancreas, artificial nutrition must satisfy nutritional requirements while avoiding stimulation of exocrine pancreatic juice observed during oral feeding. Although total parenteral nutrition (PN) induces pancreatic hyposecretion or weak pancreatic stimulation, enteral nutrition (EN) whether elementary or semi-elementary type stimulates pancreatic secretion and the release of CCK, with weaker stimulation in case of intrajejunal feeding. In acute pancreatitis, semi-elemental EN by jejunal feeding has successfully been used in the treatment of moderately serious cases, once the acute phase of the disease has been passed. Although PN remains the best indication for the treatment of pancreatic fistula, several studies have reported the closure of pancreatic fistulas during elementary enteral feeding administered by jejunal route. In the treatment of chronic pancreatitis, EN especially provides nutritional support for very undernourished patients, most often in the preoperative context. Finally, in children suffering from cystic fibrosis of the pancreas, prolonged sessions of EN provide marked improvement in the nutritional and respiratory status of these patients.