Document Detail

Nutrition support in acute pancreatitis.
MedLine Citation:
PMID:  18648127     Owner:  NLM     Status:  MEDLINE    
In the majority (80%) of patients with acute pancreatitis, the disease is self limiting and, after a few days of withholding feeding and intravenous administration of fluids, patients can again be normally fed orally. In a small percentage of patients, the disease progresses to severe necrotic pancreatitis, with an intense systemic inflammatory response and often with multiple organ dysfunction syndrome. As mortality is high in patients with severe disease and as mortality and morbidity rates are directly related to the failure of establishing a positive nitrogen balance, it is assumed that feeding will improve survival in patients with severe disease. The aim of nutritional support is to cover the elevated metabolic demands as much as possible, without stimulating pancreatic secretion and maximizing self-digestion. The administration of either total parenteral nutrition or jejunal nutrition does not stimulate pancreatic secretion. Recently, a series of controlled clinical studies has been conducted in order to evaluate the effectiveness of enteral nutrition with jejunal administration of the nutritional solution. The results have shown that enteral nutrition, as compared to total parenteral nutrition, was cheaper, safer and more effective as regards the suppression of the immunoinflammatory response, the decrease of septic complications, the need for surgery for the management of the complications of acute pancreatitis and the reduction of the total hospitalization period. It did not seem to affect mortality or the rate of non-septic complications. In conclusion, enteral nutrition should be the preferred route of nutritional support in patients with acute pancreatitis.
Orestis Ioannidis; Athina Lavrentieva; Dimitrios Botsios
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Publication Detail:
Type:  Journal Article; Review     Date:  2008-07-10
Journal Detail:
Title:  JOP : Journal of the pancreas     Volume:  9     ISSN:  1590-8577     ISO Abbreviation:  JOP     Publication Date:  2008  
Date Detail:
Created Date:  2008-07-23     Completed Date:  2008-08-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101091810     Medline TA:  JOP     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  375-90     Citation Subset:  IM    
Fourth Surgical Department, Medical School, Aristotle University, Thessaloniki, Greece.
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MeSH Terms
Dietary Supplements
Enteral Nutrition / contraindications,  methods*
Malnutrition / etiology,  prevention & control*
Pancreatitis / complications,  physiopathology*
Parenteral Nutrition / methods*

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