Enteral nutrition in acute pancreatitis: A review of the current evidence

A. Oláh, Laszlo Romics

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

The use of enteral feeding as part of the management of acute pancreatitis dates back almost two decades. This review describes the indications for and limitations of enteral feeding for the treatment of acute pancreatitis using up-to-date evidence-based data. A systematic review was carried out to analyse current data on the use of enteral nutrition in the management of acute pancreatitis. Relevant literature was analysed from the viewpoints of enteral vs parenteral feeding, early vs delayed enteral nutrition, nasogastric vs nasojejunal feeding, and early oral diet and immunonutrition, particularly glutamine and probiotic supplementation. Finally, current applicable guidelines and the effects of these guidelines on clinical practice are discussed. The latest meta- Analyses suggest that enteral nutrition significantly reduces the mortality rate of severe acute pancreatitis compared to parenteral feeding. To maintain gut barrier function and prevent early bacterial translocation, enteral feeding should be commenced within the first 24 h of hospital admission. Also, the safety of nasogastric feeding, which eases the administration of enteral nutrients in the clinical setting, is likely equal to nasojejunal feeding. Furthermore, an early low-fat oral diet is potentially beneficial in patients with mild pancreatitis. Despite the initial encouraging results, the current evidence does not support the use of immuno-enhanced nutrients or probiotics in patients with acute pancreatitis.

Original languageEnglish
Pages (from-to)16123-16131
Number of pages9
JournalWorld Journal of Gastroenterology
Volume20
Issue number43
DOIs
Publication statusPublished - Nov 21 2014

Fingerprint

Enteral Nutrition
Pancreatitis
Parenteral Nutrition
Probiotics
Small Intestine
Guidelines
Bacterial Translocation
Food
Fat-Restricted Diet
Glutamine
Meta-Analysis
Diet
Safety
Mortality

Keywords

  • Acute pancreatitis
  • Enteral nutrition
  • Immunonutrition
  • Probiotics

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Enteral nutrition in acute pancreatitis : A review of the current evidence. / Oláh, A.; Romics, Laszlo.

In: World Journal of Gastroenterology, Vol. 20, No. 43, 21.11.2014, p. 16123-16131.

Research output: Contribution to journalArticle

@article{41eebdf0453441a4a9de835f6d31a0d6,
title = "Enteral nutrition in acute pancreatitis: A review of the current evidence",
abstract = "The use of enteral feeding as part of the management of acute pancreatitis dates back almost two decades. This review describes the indications for and limitations of enteral feeding for the treatment of acute pancreatitis using up-to-date evidence-based data. A systematic review was carried out to analyse current data on the use of enteral nutrition in the management of acute pancreatitis. Relevant literature was analysed from the viewpoints of enteral vs parenteral feeding, early vs delayed enteral nutrition, nasogastric vs nasojejunal feeding, and early oral diet and immunonutrition, particularly glutamine and probiotic supplementation. Finally, current applicable guidelines and the effects of these guidelines on clinical practice are discussed. The latest meta- Analyses suggest that enteral nutrition significantly reduces the mortality rate of severe acute pancreatitis compared to parenteral feeding. To maintain gut barrier function and prevent early bacterial translocation, enteral feeding should be commenced within the first 24 h of hospital admission. Also, the safety of nasogastric feeding, which eases the administration of enteral nutrients in the clinical setting, is likely equal to nasojejunal feeding. Furthermore, an early low-fat oral diet is potentially beneficial in patients with mild pancreatitis. Despite the initial encouraging results, the current evidence does not support the use of immuno-enhanced nutrients or probiotics in patients with acute pancreatitis.",
keywords = "Acute pancreatitis, Enteral nutrition, Immunonutrition, Probiotics",
author = "A. Ol{\'a}h and Laszlo Romics",
year = "2014",
month = "11",
day = "21",
doi = "10.3748/wjg.v20.i43.16123",
language = "English",
volume = "20",
pages = "16123--16131",
journal = "World Journal of Gastroenterology",
issn = "1007-9327",
publisher = "WJG Press",
number = "43",

}

TY - JOUR

T1 - Enteral nutrition in acute pancreatitis

T2 - A review of the current evidence

AU - Oláh, A.

AU - Romics, Laszlo

PY - 2014/11/21

Y1 - 2014/11/21

N2 - The use of enteral feeding as part of the management of acute pancreatitis dates back almost two decades. This review describes the indications for and limitations of enteral feeding for the treatment of acute pancreatitis using up-to-date evidence-based data. A systematic review was carried out to analyse current data on the use of enteral nutrition in the management of acute pancreatitis. Relevant literature was analysed from the viewpoints of enteral vs parenteral feeding, early vs delayed enteral nutrition, nasogastric vs nasojejunal feeding, and early oral diet and immunonutrition, particularly glutamine and probiotic supplementation. Finally, current applicable guidelines and the effects of these guidelines on clinical practice are discussed. The latest meta- Analyses suggest that enteral nutrition significantly reduces the mortality rate of severe acute pancreatitis compared to parenteral feeding. To maintain gut barrier function and prevent early bacterial translocation, enteral feeding should be commenced within the first 24 h of hospital admission. Also, the safety of nasogastric feeding, which eases the administration of enteral nutrients in the clinical setting, is likely equal to nasojejunal feeding. Furthermore, an early low-fat oral diet is potentially beneficial in patients with mild pancreatitis. Despite the initial encouraging results, the current evidence does not support the use of immuno-enhanced nutrients or probiotics in patients with acute pancreatitis.

AB - The use of enteral feeding as part of the management of acute pancreatitis dates back almost two decades. This review describes the indications for and limitations of enteral feeding for the treatment of acute pancreatitis using up-to-date evidence-based data. A systematic review was carried out to analyse current data on the use of enteral nutrition in the management of acute pancreatitis. Relevant literature was analysed from the viewpoints of enteral vs parenteral feeding, early vs delayed enteral nutrition, nasogastric vs nasojejunal feeding, and early oral diet and immunonutrition, particularly glutamine and probiotic supplementation. Finally, current applicable guidelines and the effects of these guidelines on clinical practice are discussed. The latest meta- Analyses suggest that enteral nutrition significantly reduces the mortality rate of severe acute pancreatitis compared to parenteral feeding. To maintain gut barrier function and prevent early bacterial translocation, enteral feeding should be commenced within the first 24 h of hospital admission. Also, the safety of nasogastric feeding, which eases the administration of enteral nutrients in the clinical setting, is likely equal to nasojejunal feeding. Furthermore, an early low-fat oral diet is potentially beneficial in patients with mild pancreatitis. Despite the initial encouraging results, the current evidence does not support the use of immuno-enhanced nutrients or probiotics in patients with acute pancreatitis.

KW - Acute pancreatitis

KW - Enteral nutrition

KW - Immunonutrition

KW - Probiotics

UR - http://www.scopus.com/inward/record.url?scp=84912571889&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84912571889&partnerID=8YFLogxK

U2 - 10.3748/wjg.v20.i43.16123

DO - 10.3748/wjg.v20.i43.16123

M3 - Article

C2 - 25473164

AN - SCOPUS:84912571889

VL - 20

SP - 16123

EP - 16131

JO - World Journal of Gastroenterology

JF - World Journal of Gastroenterology

SN - 1007-9327

IS - 43

ER -