Evolution of nutritional support in acute pancreatitis

• Published in: British journal of surgery Vol. 87; no. 6; pp. 695 - 707
• Main Authors: Lobo, D. N., Memon, M. A., Allison, S. P., Rowlands, B. J.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.06.2000
• Subjects: Acute Disease; Energy Metabolism; Enteral Nutrition - methods; Humans; Nutritional Support - methods; Pancreas - secretion; Pancreatitis - diet therapy; Pancreatitis - metabolism; Pancreatitis - physiopathology; Parenteral Nutrition - methods; Randomized Controlled Trials as Topic
• ISSN: 0007-1323; 1365-2168
• DOI: 10.1046/j.1365-2168.2000.01463.x

Background: Acute pancreatitis is a catabolic illness and patients with the severe form have high metabolic and nutrient demands. Artificial nutritional support should therefore be a logical component of treatment. This review examines the evidence in favour of initiating nutritional support in these patients and the effects of such support on the course of the disease. Methods: Medline and Science Citation Index searches were performed to locate English language publications on nutritional support in acute pancreatitis in the 25 years preceding December 1999. Manual cross‐referencing was also carried out. Letters, editorials, older review articles and most case reports were excluded. Results and conclusion: There is no evidence that nutritional support in acute pancreatitis affects the underlying disease process, but it may prevent the associated undernutrition and starvation, supporting the patient while the disease continues and until normal and sufficient eating can be resumed. The safety and feasibility of enteral nutrition in acute pancreatitis have been established; enteral nutrition may even be superior to parenteral nutrition. Some patients, however, cannot tolerate enteral feeding and this route may not be practical in others. Parenteral nutrition still has a role, either on its own or in combination with the oral and enteral routes, depending on the stage of the illness and the clinical situation. © 2000 British Journal of Surgery Society Ltd