Abstract
Nasojejunal tube feeding is considered the current standard of care in patients with severe and critical acute pancreatitis. However, it is not known whether enteral nutrition is best delivered into the jejunum. This Commentary discusses recent clinical studies that have shown that tube feeding into the stomach is safe and well tolerated in the vast majority of patients with acute pancreatitis, thus overthrowing the notion of putting the pancreas at rest. Development of a new conceptual framework is warranted to further advance nutritional management of patients with acute pancreatitis.
Highlights
Nasojejunal tube feeding is considered the current standard of care in patients with severe and critical acute pancreatitis
‘non-stimulatory’ nutrition had been widely advocated, being total parenteral nutrition two to three decades ago and nasojejunal tube feeding in the past decade
It demonstrates that the evidence base is relatively small but does show that enteral nutrition given via the nasogastric route is well tolerated in more than 90% of patients with acute pancreatitis (AP) [9,10,11]
Summary
Nasojejunal tube feeding is considered the current standard of care in patients with severe and critical acute pancreatitis. Enteral nutrition is a rapidly evolving frontier in the management of acute pancreatitis (AP). The central tenet of this concept is that enteral nutrition delivered into any part of the upper gastrointestinal tract other than the jejunum stimulates pancreatic secretion and, exacerbates the severity of AP.
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