Dietary management of acute pancreatitis

Our reporter Wu Xueqin correspondent Zhuang Pengxia Lian Xue'e

Over the years, many textbooks have regarded acute pancreatitis as an absolute contraindication to enteral nutrition or oral nutrition.

Pathophysiological characteristics and effects on nutrient digestion

Acute pancreatitis is an inflammatory disease caused by gallstones blocking the pancreatic duct, trauma to the pancreas, and acute alcohol load

The basic pathogenic factor of acute pancreatitis is self-digestion caused by self-activation of pancreatic enzymes in the pancreas

The nutritional support for acute pancreatitis is still controversial, but there is a relatively unified view

Nutritional support

Nutritional treatment plan for mild to moderate pancreatitis:

The first stage (2-5 days): fasting, infusion, pain relief

Stage 2 (3-7 days): Pain disappears, amylase declines - Eating (from less to more, gradually increasing) - Complex carbohydrates - Moderate protein - Low to moderate fat

Stage 3: Return to normal eating and avoid excess fat

Nutritional therapy for severe pancreatitis:

1.

2.

3.

　　4.

　　5.

　　6.

　　7.

Diet nutrition during recovery

　　1.

　　2.

　　3.
Avoid foods that cause gastric juice and pancreatic juice secretion, such as broth, chicken soup, fish soup, milk, egg yolk,
etc.

　　4.
Prohibition of drinking, avoid overeating
.

　　5.
The intake of fat can be transitioned from a strict restriction (20g/d) to a moderately restricted fat diet (40g/d), and a mild fat restriction can be tolerated when the condition improves
.
If necessary, medium-chain triglycerides can also be used to replace part of long-chain triglycerides, and cooking methods that use less oil such as steaming, boiling, stewing, and stewing are mostly used
.

　　In conclusion, any type of acute pancreatitis requires fluid therapy
.
Parenteral nutrition or invasive enteral nutrition support is generally not required for mild to moderate acute pancreatitis
.
For severe pancreatitis, early enteral nutrition support may reduce the incidence of nosocomial infection, reduce the duration of systemic inflammatory response, and reduce the overall severity of the disease.
If the patient can tolerate it, early enteral nutrition should be recommended
.
However, if enteral nutrition cannot achieve the predetermined nutritional support effect, parenteral nutrition must be used, but attention should be paid to assisting a small amount of enteral nutrition to maintain the permeability of the intestinal mucosa
.
To be able to eat ordinary food after recovering from the disease, it is also necessary to master the principle of gradually adding from less to more
.

　　Liu Deting, Department of Gastroenterology, Hui'an County Hospital, Fujian Province, attending physician; 3 years of standardized training in the internal medicine system of the First Hospital of Quanzhou City
.
Currently engaged in clinical work in internal medicine for 8 years, has rich clinical experience in gastroenterology and other diseases of the large internal medicine system, common diseases, frequently-occurring diseases and other diseases
.

 

　　"China Food News" (03 edition on October 22, 2021)

(Editor in charge: Luo Chen)