Chronic Pancreatitis and Nutrition Therapy

Nutr Clin Pract. 2019 Oct:34 Suppl 1:S13-S26. doi: 10.1002/ncp.10379.

Abstract

Chronic pancreatitis is a complex and irreversible disease of the pancreas and is associated with significant morbidity and mortality. Nutrition deficiencies in chronic pancreatitis are common and can be atypical in nature. As such, the management of these deficiencies can be individualized for patients. The aim of this review is to discuss the components of nutrition deficiencies in chronic pancreatitis, their management, and the current areas of research that are being explored. The clinical guidelines of major national and international societies were analyzed for recommendations on the nutrition management of chronic pancreatitis. The etiology of nutrition deficiencies in chronic pancreatitis is multifactorial and includes aspects of exocrine and/or endocrine dysfunction, significant abdominal pain, often persistent alcohol consumption, and increased metabolic activity. A large number of patients with nutrition deficiencies are underrecognized and undertreated. Although the majority of these patients can be managed by oral and pancreatic enzyme supplementation, some patients may require enteral tube feeding and, in rare cases, parenteral feeding. Current areas of research include the accurate identification of patients at risk for nutrition deficiencies, optimization of feeding regimens, and research into islet cell autotransplantation.

Keywords: chronic pancreatitis; diabetes mellitus; endocrine dysfunction; enteral nutrition; exocrine dysfunction; exocrine pancreatic insufficiency; malnutrition; nutrition deficiencies; nutrition support; sarcopenia.

Publication types

  • Review

MeSH terms

  • Chronic Disease
  • Humans
  • Malnutrition / etiology
  • Malnutrition / therapy*
  • Nutrition Assessment
  • Nutritional Status
  • Nutritional Support / methods*
  • Pancreatitis, Chronic / complications
  • Pancreatitis, Chronic / therapy*