Nutritional management of patients with feeding-induced pain: acute pancreatitis

A 36-year-old women with severe acute pancreatitis induced by familial hyperlipidemia is presented. Ranson's score, APACHE-II score, assessment of organ function, and a computed tomography scan are used to diagnose the severity of pancreatitis. Withholding oral alimentation, parenteral analgesia, fluid resuscitation, and antibiotics all serve important roles in management of this disease. Protein-calorie malnutrition can easily develop as a result of no oral intake and hypercatabolism. Tube feeding into the jejunum using a partially hydrolyzed formula has been reported in modest to severe pancreatitis. If tube feeding is not tolerated or a feeding tube cannot be properly positioned, parenteral nutrition may be necessary to maintain bowel rest. Parenteral nutrition administered to patients with pancreatitis is associated with catheter-related infection, hyperglycemia, and hypertriglyceridemia. These complications can be managed through careful design of parenteral solutions and close monitoring.