Full-text resources of PSJD and other databases are now available in the new Library of Science.
Visit https://bibliotekanauki.pl


Preferences help
enabled [disable] Abstract
Number of results


2014 | 9 | 4 | 574-579

Article title

Nutrition in acute pancreatitis: a review


Title variants

Languages of publication



We perform an update about nutritional measures that have been adopted in patients with acute pancreatitis (AP). The nutritional support is an essential part of treatment in AP. When the AP is mild or moderate, there is no doubt that is not necessary to use an artificial nutritional support, and it is recommended that oral nutritional support should begin as soon as possible. If the AP is severe, the best way to provide nutritional support is through enteral nutritional (EN) because it reduces infection, length of hospitalization and mortality rate. Parenteral nutrition (PN) should be used only when EN is Impossible. However, there is no scientific evidence for recommending the most optimal route necessary to administer this type of nutritional support; we seek to uncover whether this is by gastric or jejunal route and the proper formula to use. There is an international agreement that the nutritional support should begin quickly, within the first 24 and 72 hours of hospitalization. As conclusion, more research needs to be done concerning nutritional support in AP, and many questions are not been answered yet.











Physical description


1 - 8 - 2014
19 - 7 - 2014


  • Unidad de Nutrición, Servicio de Endocrinología, Hospital Universitario de Guadalajara, Guadalajara, Spain
  • Unidad de Nutrición, Servicio de Endocrinología, Hospital Universitario de Guadalajara, Guadalajara, Spain
  • Unidad de Nutrición, Servicio de Endocrinología, Hospital Universitario de Guadalajara, Guadalajara, Spain


  • [1] Swaroop VS, Chari ST, Clain JE. Severe acute pancreatitis. JAMA 2004; 291(23):2865–2868 http://dx.doi.org/10.1001/jama.291.23.2865[Crossref]
  • [2] Pezzilli R, Uomo G, Zerbi A, Gabbrielli A, Frulloni L, et al. Diagnosis and treatment of acute pancreatitis: the position statement of the Italian Association for the study of the pancreas. Dig Liver Dis 2008; 40: 803–808 http://dx.doi.org/10.1016/j.dld.2008.02.019[Crossref]
  • [3] McClave SA, Greene LM, Snider HL, Makk LJ, Cheadle WG, Owens NA, Dukes LG, Goldsmith LJ. Comparison of the safety of early enteral vs parenteral nutrition in mild acute pancreatitis. JPEN J Parenter Enteral Nutr 1997; 21:14–20 http://dx.doi.org/10.1177/014860719702100114[Crossref]
  • [4] Abou-Assi S, O’Keefe SJ. Nutrition in acute pancreatitis. J Clin Gastroenterol 2001; 32:203–209 http://dx.doi.org/10.1097/00004836-200103000-00004[Crossref]
  • [5] Meier R, Beglinger C, Layer P, Gullo L, Keim V, Laugier R, Friess H, Schweitzer M, Macfie J. ESPEN guidelines on nutrition in acute pancreatitis. Clin Nutr 2002; 21:173–83 http://dx.doi.org/10.1054/clnu.2002.0543[Crossref]
  • [6] Sax HC, Warner BW, Talamini MA, Hamilton FN, Bell RH Jr, Fischer JE et al. Early total parenteral nutrition in acute pancreatitis: lack of beneficial effects. Am J Surg 1987; 153:117–124 http://dx.doi.org/10.1016/0002-9610(87)90211-X[Crossref]
  • [7] Petrov MS, Pylypchuk RD, Emelyanov NV. Systematic review: nutritional support in acute pancreatitis. Aliment Pharmacol Ther 2008; 28:704–712 http://dx.doi.org/10.1111/j.1365-2036.2008.03786.x[WoS][Crossref]
  • [8] American Gastroenterological Association (AGA) Institute on “Management of Acute Pancreatits” Clinical Practice and Economics Committee; AGA Institute Governing Board. AGA Institute medical position statement on acute pancreatitis. Gastroenterology 2007; 132:2019–2021 http://dx.doi.org/10.1053/j.gastro.2007.03.066[Crossref]
  • [9] Takeda K, Takada T, Kawarada Y, Hirata K, Mayumi T, Yoshida M et al. JPN Guidelines for the management of acute pancreatitis: medical management of acute pancreatitis. J Hepatobiliary Pancreat Surg 2006; 13:42–47 http://dx.doi.org/10.1007/s00534-005-1050-8[Crossref]
  • [10] Navarro S, Amador J, Argüello L, Ayuso C, Boadas J, de Las Heras G et al; Club Español Biliopancreático para el Tratamiento de la Pancreatitis Aguda. [Recommendations of the Spanish Biliopancreatic Club for the Treatment of Acute Pancreatitis. Consensus development conference]. Gastroenterología y Hepatología 2008; 31:366–387 http://dx.doi.org/10.1157/13123605[Crossref]
  • [11] Meier R, Ockenga J, Pertkiewicz M, Pap A, Milinic N, Macfie J; DGEM (German Society for Nutritional Medicine), Löser C, Keim V; ESPEN (European Society for Parenteral and Enteral Nutrition). ESPEN Guidelines on Enteral Nutrition: Pancreas. Clin Nutr 2006; 25:275–284 http://dx.doi.org/10.1016/j.clnu.2006.01.019[Crossref]
  • [12] Sathiaraj E, Murthy S, Mansard MJ, Rao GV, Mahukar S, Reddy DN. Clinical trial: oral feeding with a soft diet compared with clear liquid diet as initial meal in mild acute pancreatitis. Aliment Pharmacol Ther 2008; 28:777–781 http://dx.doi.org/10.1111/j.1365-2036.2008.03794.x[Crossref][WoS]
  • [13] Jacobson BC, Vander Vliet MB, Hughes MD, Maurer R, McManus K, Banks PA. A prospective, randomized trial of clear liquids versus low-fat solid diet as the initial meal in mild acute pancreatitis. Clin Gastroenterol Hepatol 2007; 5:946–951 http://dx.doi.org/10.1016/j.cgh.2007.04.012[Crossref]
  • [14] Petrov MS, et al., Early nasogastric tube feeding versus nil per os in mild to moderate acute pancreatitis: A randomized controlled trial, Clinical Nutrition (2013), http://dx.doi.org/10.1016/j.clnu.2012.12.011 [Crossref]
  • [15] Gianotti L, Meier R, Lobo DN, Bassi C, Dejong CH, Ockenga J, et al; ESPEN. ESPEN Guidelines on Parenteral Nutrition: pancreas. Clin Nutr 2009; 28:428–435 [Crossref]
  • [16] McClave SA, Martindale RG, Vanek VW, McCarthy M, Roberts P, Taylor B, et al; ASPEN. Board of Directors; American College of Critical Care Medicine. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically III Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN). JPEN J Parenter Enteral Nutr 2009; 33:277–316 http://dx.doi.org/10.1177/0148607109335234[WoS][Crossref]
  • [17] Al-Omran M, Groof A, Wilke D. Enteral versus parenteral nutrition for acute pancreatitis. Cochrane Database Syst Rev. 2001;CD002837. Review. Update in: Cochrane Database Syst Rev. 2003: CD002837 [WoS]
  • [18] Marik PE, Zaloga GPL. Meta-analysis of parenteral nutrition versus enteral nutrition in patients with acute pancreatitis. BMJ 2004; 328;1407–1412 http://dx.doi.org/10.1136/bmj.38118.593900.55[Crossref]
  • [19] 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; 30:143–156 http://dx.doi.org/10.1177/0148607106030002143[Crossref]
  • [20] Petrov MS, Van Santvoort HC, Besselink MG, Van der Heijden GJ, Windsor JA, Gooszen HG. Enteral nutrition and the risk of mortality and infectious complications in patients with severe acute pancreatitis: a meta-analysis of randomized trials. Arch Surg 2008; 143:1111–1117 http://dx.doi.org/10.1001/archsurg.143.11.1111[Crossref][WoS]
  • [21] Heming Q, Xingpeng W, Chuanyong G. A Meta-Analysis of Enteral Nutrition and Total Parenteral Nutrition in Patients with Acute Pancreatitis. Gastroenterology Research and Practice Volume 2011, Gastroenterology Research and Practice Volume 2011, Article ID 698248, 9 pages doi:10.1155/2011/698248 [Crossref]
  • [22] Petrov MS, Zagainov VE. Influence of enteral versus parenteral nutrition on blood glucose control in acute pancreatitis: a systematic review. Clin Nutr 2007; 26:514–523 http://dx.doi.org/10.1016/j.clnu.2007.04.009[Crossref]
  • [23] Sun E, Tharakan M, Kapoor S, Chakravarty R, Salva A, Buscaglia JM, Nagula S. Poor Compliance with ACG Guidelines for Nutrition and Antibiotics in the Management of Acute Pancreatitis: A North American Survey of Gastrointestinal Specialists and Primary Care Physicians. JOP. J Pancreas (Online) 2013 May 10; 14(3):221–227
  • [24] Niederau C., Niederau M, Lüthen R, Strohmeyer G, Ferrell LD, Grendell JH. Pancreatic exocrine secretion in acute experimental pancreatitis. Gastroenterology 1990; 99:1120–1127
  • [25] Eatock FC, Brombacher GD, Steven A, Imrie CW, McKay CJ, Carter R. Nasogastric feeding in severe acute pancreatitis may be practical and safe. Int J Pancreatol 2000; 28:23–29 http://dx.doi.org/10.1385/IJGC:28:1:23[Crossref]
  • [26] Eatock FC, Chong P, Menezes N, Murray L, McKay CJ, Carter CR, Imrie CW. A randomized study of early nasogastric versus nasojejunal feeding in severe acute pancreatitis. Am J Gastroenterol. 2005; 100:432–439 http://dx.doi.org/10.1111/j.1572-0241.2005.40587.x[Crossref]
  • [27] Jiang K, Chen XZ, Xia Q, Tang WF, Wang L. Early nasogastric enteral nutrition for severe acute pancreatitis: a systematic review. World J Gastroenterol 2007; 13:5253–5260 [Crossref][WoS]
  • [28] Petrov MS, Correia MI, Windsor JA. Nasogastric tube feeding in predicted severe acute pancreatitis. A systematic review of the literatura to determine safety and tolerance. JOP 2008; 9:440–448
  • [29] Banks PA, Freeman ML; Practice Parameters Committee of the American College of Gastroenterology. Practice guidelines in acute pancreatitis. Am J Gastroenterol 2006; 101:2379–2400 http://dx.doi.org/10.1111/j.1572-0241.2006.00856.x[Crossref]
  • [30] Bakker OJ, Van Santvoort HC, Van Brunschot S, Ahmed Ali U, Besselink MG, Boermeester MA, et al. Pancreatitis, very early compared with normal start of enteral feeding (PYTHON trial): design and rationale of a randomised controlled multicenter trial. Trials 2011; 12:73 http://dx.doi.org/10.1186/1745-6215-12-73[Crossref]
  • [31] Tiengou LE, Gloro R, Pouzolet J, Bouhier K, Read MH, Arnaud-Battandier F, et al. Semi-elemental formula or polymeric formula: is there a better choice for enteral nutrition in acute pancreatitis? Randomized comparative study. JPEN J Parenter Enteral Nutr 2006; 30:1–5 http://dx.doi.org/10.1177/014860710603000101[Crossref]
  • [32] Petrov MS, Loveday BP, Pylypchuk RD, McIlroy K, Phillips AR, Windsor JA. Systematic review and meta-analysis of enteral nutrition formulations in acute pancreatitis. Br J Surg 2009; 96(11):1243–1252 http://dx.doi.org/10.1002/bjs.6862[Crossref]
  • [33] Novak F, Heyland DK, Avenell A, Drover JW, Su X. Glutamine supplementation in serious illness: a systematic review of the evidence. Crit Care Med. 2002 Sep; 30(9):2022–2029 http://dx.doi.org/10.1097/00003246-200209000-00011[Crossref]
  • [34] Dechelotte P, Hasselmann M, Cynober L, Allaouchiche B, Coeffier M, Hecketsweiler B, et al. l-Alanyl-l-glutamine dipeptide-supplemented total parenteral nutrition reduces infectious complications and glucose intolerance in critically ill patients: the French controlled, randomized, doubleblind, multicenter study. Crit Care Med. 2006 Mar; 34(3):598–604 http://dx.doi.org/10.1097/01.CCM.0000201004.30750.D1[Crossref]
  • [35] Gianotti L, Meier R, Lobo DN, Bassi C., Dejong CH, Ockenga J, et al; ESPEN. ESPEN Guidelines on Parenteral Nutrition: pancreas. Clin Nutr 2009; 28:428–435 http://dx.doi.org/10.1016/j.clnu.2009.04.003[Crossref]
  • [36] Ockenga J, Borchert K, Rifai K, Manns MP, Bischoff SC. Effect of glutamine-enriched total parenteral nutrition in patients with acute pancreatitis. Clin Nutr. 2002; 21:409–416 http://dx.doi.org/10.1054/clnu.2002.0569[Crossref]
  • [37] De Beaux AC, O’Riordain MG, Ross JA, Jodozi L, Carter DC, Fearon KC. Glutamine-supplemented total parenteral nutrition reduces blood mononuclear cell interleukin-8 release in severe acute pancreatitis. Nutrition. 1998; 14:261–265 http://dx.doi.org/10.1016/S0899-9007(97)00477-2[Crossref]
  • [38] Zhao G, Wang CY, Wang F, Xiong JX. Clinical study on nutrition support in patients with severe acute pancreatitis. World J Gastroenterol. 2003; 9:2105–108
  • [39] Karakan T, Ergun M, Dogan I, Cindoruk M, Unal S. Comparison of early enteral nutrition in severe acute pancreatitis with prebiotic fiber supplementation versus standard enteral solution: a prospective randomized double-blind study. World J Gastroenterol. 2007 May 21; 13(19):2733–2737
  • [40] Oláh A, Belágyi T, Issekutz A, Gamal ME, Bengmark S. Randomized clinical trial of specific lactobacillus and fibre supplement to early enteral nutrition in patients with acute pancreatitis. Br J Surg 2002; 89:1103–1107 http://dx.doi.org/10.1046/j.1365-2168.2002.02189.x[Crossref]
  • [41] Besselink MG, Van Santvoort HC, Buskens E, Boermeester MA, Van Goor H, Timmerman HM, et al. Dutch Acute Pancreatitis Study Group. Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial. Lancet 2008; 371:651–9. [WoS]
  • [42] Oláh T, Belágyi L, Pótó L, Romics Jr, S. Bengmark, “Synbiotic control of inflammation and infection in severe acute pancreatitis: a prospective, randomized, double blind study,” Hepatogastroenterology, 2007; 54(74):590–594
  • [43] Besselink MG, Van Santvoort HC, Van Santvoort HC. Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebocontrolled trial. The Lancet 2008; 371:651–659 http://dx.doi.org/10.1016/S0140-6736(08)60207-X[Crossref]
  • [44] Ming-Ming Z, Jing-Qiu Ch, Yan-Rong L, Zhi-Hui Y, Ping Y, Xiao-Ting W. Use of pre-, pro- and synbiotics in patients with acute pancreatitis: A metaanalysis. World J Gastroenterol 2010; 16(31): 3970–3978 http://dx.doi.org/10.3748/wjg.v16.i31.3970[Crossref][WoS]
  • [45] N., Hamvas J., Biró L., Németh E., Marosvölgyi T., Decsi T., Pap A., Antal M. Effect of enterally administered n-3 polyunsaturated fatty acids in acute pancreatitis-a prospective randomized clinical trial. Clin Nutr 2005; 24:198–205 http://dx.doi.org/10.1016/j.clnu.2004.12.008[Crossref]
  • [46] Pearce CB, Sadek SA, Walters AM, Goggin PM, Somers SS, Toh SK, et al. A double-blind, randomised, controlled trial to study the effects of an enteral feed supplemented with glutamine, arginine, and omega-3 fatty acid in predicted acute severe pancreatitis. JOP 2006; 7: 361–371

Document Type

Publication order reference


YADDA identifier

JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.