Nutrition Support in Pancreatitis: Beyond Parenteral Nutrition

19 INTRODUCTION P ancreatitis is caused by activation of pancreatic digestive enzymes within the pancreas leading to pain and inflammation (1). The inflammatory response to pancreatitis is similar to that of sepsis and can precipitate systemic inflammatory response syndrome (SIRS). SIRS can lead to multiple system organ failure, sepsis, hypermetabolism, hypercatabolism, and increased mortality in severe cases (2,3,4,5). The integrity of the gastrointestinal tract may also be affected by SIRS by increasing the intestinal permeability and altering the normal gut barrier with resultant bacterial translocation potential (2,3,6,7,8). Seventy to eighty percent of hospitalizations due to pancreatitis are mild cases resolving in 5–7 days with only conventional therapy that includes fluid resuscitation, pain management, antibiotic therapy, and withholding oral intake to avoid pain exacerbation (3,9,10,11). Nutrition Support in Pancreatitis: Beyond Parenteral Nutrition NUTRITION SUPPORT IN GASTROENTEROLOGY, SERIES #1