Nutritional management of acute pancreatitis.

PURPOSE OF REVIEW: Acute pancreatitis is one of the most common causes for hospitalization related to a gastrointestinal disorder. It carries significant morbidity, and when severe, significant mortality. Multiple interventions have been studied to treat pancreatitis. Of all these interventions, none is more important or impactful than nutrition.

RECENT FINDINGS: High-quality evidence along with society guidelines have recommended the use of enteral nutrition over parenteral nutrition in patients with pancreatitis. Recent systematic reviews and meta-analyses have been published and will be reviewed here.

SUMMARY: The use of enteral nutrition has been demonstrated to decrease mortality and infectious complications compared with parenteral nutrition. The ideal timing of initiating enteral nutrition is not clear, however, early nutrition (within 48 h) appears to be safe and tolerated. Most studies have utilized nasojejunal feeding tubes; however, some patients may tolerate nasogastric or even oral refeeding. Clinicians who manage patients with pancreatitis must be aware of the critical role of nutrition in preventing pancreatitis-related complications.