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Nutrition management and pancreatitis in children: new insights
Chinenye R Dike1, Maisam Abu-El-Haija2,3
1Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Nebraska Medical Center, and Children's Hospital and Medical Center Omaha, NE.
Insights
Early feeding is safe for children with mild to moderate acute pancreatitis (AP). Starting nutrition within 48 hours improves outcomes and reduces hospital stay, unlike remaining nil per os (NPO).
Area of Science:
- Pediatric Gastroenterology
- Clinical Nutrition
- Pancreatology
Background:
- Nutrition is crucial for managing pediatric acute pancreatitis (AP).
- Dietary management before, during, and after AP impacts patient outcomes.
- Recent advancements in nutritional interventions for pediatric AP have been observed over the last decade.
Purpose of the Study:
- To review recent advances in nutritional interventions for pediatric acute pancreatitis.
- To highlight the importance of diet in AP management.
- To identify future research directions in pediatric AP nutrition.
Main Methods:
- Literature review of studies on nutritional interventions in pediatric AP.
- Analysis of outcomes associated with early enteral nutrition versus nil per os (NPO).
- Evaluation of the safety and feasibility of early feeding in mild to moderate pediatric AP.
Main Results:
- Early initiation of enteral nutrition (within 48 hours) is safe and feasible in mild to moderate pediatric AP.
- Compared to NPO, early enteral nutrition significantly reduces length of stay, progression to severe AP, and ICU transfers.
- Early standard fat meals did not exacerbate pain or increase serum lipase levels in children with mild to moderate AP.
- Early enteral nutrition is associated with improved outcomes and increased weight gain at follow-up.
Conclusions:
- Early enteral nutrition is a safe and effective strategy for managing mild to moderate pediatric acute pancreatitis.
- Further research is needed to establish the role of early enteral nutrition in severe pediatric AP.
- Nutritional interventions play a vital role in improving outcomes for children with AP.
Recent Findings:
Early initiation of feeds is safe and possible in mild to moderate pediatric acute pancreatitis (AP) and is not associated with increased pain or increased serum lipase level. Enteral nutrition within 48 h of admission compared to no feeds within 48 h (NPO) is associated with a significant reduction in length of stay, reduced progression to severe acute pancreatitis, decreased ICU transfers, and increased weight gain at follow-up. Early standard fat meals did not worsen pain or serum lipase levels in children with mild to moderate AP.
Purpose Of Review:
Nutrition is essential in the management of AP in children. Diet before, during, and after an attack of AP can affect outcomes. Here, we highlight recent advances that have been made in the last decade on nutritional interventions in pediatric acute pancreatitis and provide future directions for research.
Summary:
Early enteral nutrition is safe and feasible in pediatric mild to moderate AP and is associated with improved outcomes. There are only a handful of studies on nutritional interventions in pediatric mild to moderate AP. Further studies are needed to understand the effects of early enteral nutrition in pediatric severe AP.
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