Role of Enteral and Parenteral Nutrition

Abstract

As previously demonstrated, acute pancreatitis can be regarded as a hyper catabolism state and nutrition plays a key role in the treatment of this disease. When patient’s food intake is limited because of pancreatic pain, organ failure or other, an adapted nutrition support should be initiated early in the management of acute pancreatitis in order to decrease mortality and morbidity. Numerous meta-analyses addressing this issue have been published and the most appropriate modalities for artificial nutrition are now wellestablished. Compared to parenteral nutrition, enteral nutrition has been shown to have a greater clinical benefit in patients with acute pancreatitis reducing the risk of developing both, pancreatic infections and multiple organ failure. Enteral nutrition may attenuate the mucosal barrier breakdown and subsequent bacterial translocation. It also may increase the intestinal motility and decrease bacterial overgrowth. The international guidelines recommend that enteral nutrition in acute pancreatitis should be administered via either the nasojejunal or nasogastric route but the choice of the location should not delay the nutritional support. Either elemental or polymeric enteral nutrition formulations can be used in acute pancreatitis.