Acute Pancreatitis: How Soon Should We Feed Patients?
Authors: Kristen M. Roberts, Darwin Conwell
Journal: Annals of Internal Medicine (2017)

Editorials20 June 2017Acute Pancreatitis: How Soon Should We Feed Patients?Kristen M. Roberts, PhD, RD, LD and Darwin Conwell, MDKristen M. Roberts, PhD, RD, LDFrom The Ohio State University, Columbus, Ohio.Search for more papers by this author and Darwin Conwell, MDFrom The Ohio State University, Columbus, Ohio.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-1123 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Management of nutrition in the setting of acute pancreatitis varies and can include oral, enteral, or parenteral nutrition. Most agree that maintenance of gut barrier function in acute pancreatitis is best achieved through the use of enteral rather than parenteral nutrition in patients requiring specialized nutrition support (1–4). Characteristics of enteral nutrition that may affect gastrointestinal tolerance in patients with acute pancreatitis include the method of delivery (bolus vs. continuous), the formula (monomeric, oligomeric, polymeric, immune-modulating, fiber, or fiber-free), and the delivery route (gastric vs. jejunal). Current literature supports the use of a polymeric formula (2) delivered through either a ...References1. McClave SA, Chang WK, Dhaliwal R, Heyland DK. Nutrition support in acute pancreatitis: a systematic review of the literature. JPEN J Parenter Enteral Nutr. 2006;30:143-56. [PMID: 16517959] CrossrefMedlineGoogle Scholar2. McClave SA, Taylor BE, Martindale RG, Warren MM, Johnson DR, Braunschweig C, et al; Society of Critical Care Medicine. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr. 2016;40:159-211. [PMID: 26773077] doi:10.1177/0148607115621863 CrossrefMedlineGoogle Scholar3. Marik PE, Zaloga GP. Early enteral nutrition in acutely ill patients: a systematic review. Crit Care Med. 2001;29:2264-70. [PMID: 11801821] CrossrefMedlineGoogle Scholar4. Cao Y, Xu Y, Lu T, Gao F, Mo Z. Meta-analysis of enteral nutrition versus total parenteral nutrition in patients with severe acute pancreatitis. Ann Nutr Metab. 2008;53:268-75. [PMID: 19136822] doi:10.1159/000189382 CrossrefMedlineGoogle Scholar5. Chang YS, Fu HQ, Xiao YM, Liu JC. Nasogastric or nasojejunal feeding in predicted severe acute pancreatitis: a meta-analysis. Crit Care. 2013;17:R118. [PMID: 23786708] doi:10.1186/cc12790 CrossrefMedlineGoogle Scholar6. Vaughn VM, Shuster D, Rogers MAM, Mann J, Conte ML, Saint S, et al. Early versus delayed feeding in patients with acute pancreatitis. A systematic review. Ann Intern Med. 2017;166:883-92. doi:10.7326/M16-2533 LinkGoogle Scholar7. Chokkalingam A, Scherer R, Dickersin K. Concordance of data between conference abstracts and full reports. In: Systematic Reviews: Evidence for Action. Abstracts of the 6th Cochrane Colloquium, Baltimore, Maryland, 22–26 October 1998. Google Scholar8. Wang G, Wen J, Xu L, Zhou S, Gong M, Wen P, et al. Effect of enteral nutrition and ecoimmunonutrition on bacterial translocation and cytokine production in patients with severe acute pancreatitis. J Surg Res. 2013;183:592-7. [PMID: 23726433] doi:10.1016/j.jss.2012.12.010 CrossrefMedlineGoogle Scholar9. Lasztity N, Hamvas J, Biró L, Németh E, Marosvölgyi T, Decsi T, et al. Effect of enterally administered n-3 polyunsaturated fatty acids in acute pancreatitis—a prospective randomized clinical trial. Clin Nutr. 2005;24:198-205. [PMID: 15784478] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From The Ohio State University, Columbus, Ohio.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-1123.Corresponding Author: Kristen M. Roberts, PhD, RD, LD, The Ohio State University, 395 West 12th Avenue, Second Floor, Columbus, OH 43210; e-mail, Kristen.[email protected]edu.Current Author Addresses: Drs. Roberts and Conwell: The Ohio State University, 395 West 12th Avenue, Second Floor, Columbus, OH 43210.This article was published at Annals.org on 16 May 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEarly Versus Delayed Feeding in Patients With Acute Pancreatitis Valerie M. Vaughn , Dmitry Shuster , Mary A.M. Rogers , Jason Mann , Marisa L. Conte , Sanjay Saint , and Vineet Chopra Metrics Cited byMultidisciplinary Management of Complicated Pancreatitis: What Every Interventional Radiologist Should KnowNutritional Aspects of Acute Pancreatitis 20 June 2017Volume 166, Issue 12Page: 903-904KeywordsAcute pancreatitisDietHospitalizationsLength of stayMorbidityMortalityNutritionPancreatitisSystematic reviewsTreatment guidelines ePublished: 16 May 2017 Issue Published: 20 June 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...