Detrimental and Beneficial Diets Regulate Acute Pancreatitis Through Convergent Gut Microbiota Pathways

Diet is a key factor in regulating gut microbiota homeostasis, thereby influencing the incidence, severity, and prognosis of acute pancreatitis (AP). This review categorizes common dietary patterns into harmful types (Western diet, high-fat diet, ketogenic diet, high-salt diet) and beneficial types (Mediterranean diet, high-fiber diet, plant-based diet, restricted diet). Unlike previous reviews that list dietary patterns one by one, this paper analyzes them within the framework of the four core pathological/protective pathways of AP. Harmful diets primarily exacerbate AP by inducing dysbiosis, reducing SCFAs (especially butyrate), impairing the gut barrier, promoting bacterial translocation and excessive inflammatory responses; beneficial diets alleviate AP progression by enriching probiotics, increasing SCFA synthesis, enhancing barrier integrity, and suppressing systemic inflammation. This paper particularly emphasizes that most current evidence comes from non-AP models such as obesity and inflammatory bowel disease, and AP-specific causal evidence remains very limited. By integrating clinical, animal, and cellular experimental evidence, this paper aims to elucidate the potential relationship between diet, gut microbiota, and AP, and to provide a theoretical basis for dietary intervention strategies targeting the gut microbiota.