Nutrition in acute pancreatitis

Area of Science:

• Gastroenterology
• Clinical Nutrition

Background:

• Acute pancreatitis (AP) presents with varying severity, with severe cases leading to prolonged hospitalization and increased intervention needs.
• Patients with severe AP face a significant risk of malnutrition due to the disease's metabolic demands and potential for prolonged fasting.
• Current pharmacotherapy for AP is limited, underscoring the importance of supportive care, including nutritional interventions.

Purpose of the Study:

• To highlight the critical role of nutritional support in managing acute pancreatitis.
• To compare the efficacy and benefits of enteral nutrition (EN) versus parenteral nutrition (PN) in AP patients.
• To review the evidence for adjunctive therapies in AP management.

Main Methods:

• Literature review focusing on nutritional strategies in acute pancreatitis.
• Analysis of studies comparing enteral nutrition (EN) with parenteral nutrition (PN).
• Evaluation of evidence for probiotics, glutamine, antioxidants, and pancreatic enzymes in AP.

Main Results:

• Enteral nutrition (EN) is the preferred route, offering physiological benefits and reducing infection, intervention, and mortality rates.
• Parenteral nutrition (PN) is reserved for specific cases where EN is not feasible.
• No proven benefits were found for probiotics, glutamine supplementation, antioxidants, or pancreatic enzyme replacement therapy in AP.

Conclusions:

• Nutritional management, particularly enteral nutrition (EN), is a cornerstone of acute pancreatitis (AP) care.
• EN demonstrates superior outcomes compared to PN in AP, reducing complications and improving survival.
• Adjunctive therapies like probiotics and glutamine lack proven efficacy in AP management.