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Clinical nutrition in pancreatitis
S A McClave1, H Snider, N Owens
1Division of Gastroenterology/Hepatology, University of Louisville School of Medicine, Kentucky 40292, USA.
Digestive Diseases and Sciences
|November 19, 1997
Summary
Nutritional support is crucial for acute pancreatitis patients due to increased needs and poor intake. Jejunal feeding may be superior to parenteral nutrition for managing this condition.
Area of Science:
- Gastroenterology
- Nutritional Science
- Critical Care Medicine
Background:
- Acute pancreatitis presents a hypermetabolic state, increasing protein/calorie needs.
- Patients often experience reduced nutrient intake and assimilation, leading to malnutrition.
- Severe pancreatitis cases necessitate aggressive nutritional support.
Purpose of the Study:
- To explore nutritional management strategies in acute and chronic pancreatitis.
- To evaluate the impact of feeding routes on pancreatic exocrine secretion.
- To compare enteral nutrition with parenteral alimentation for pancreatitis patients.
Main Methods:
- Review of animal studies and human prospective randomized controlled trials.
- Analysis of factors influencing pancreatic exocrine secretion (formula type, infusion site).
- Assessment of nutritional support requirements based on pancreatitis severity (Ranson criteria, APACHE II).
Main Results:
- Enteral nutrition via jejunal feeding may stimulate pancreatic exocrine secretion less than other methods.
- Severe pancreatitis patients require more intensive nutritional support.
- Jejunal feeding is suggested as a preferred route over parenteral nutrition.
Conclusions:
- Enteral nutrition, particularly via jejunal feeding, shows promise in managing pancreatitis-associated malnutrition.
- Optimizing nutrient delivery is key to preventing nutritional deterioration in pancreatitis.
- Further research into optimal enteral feeding strategies is warranted.
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