Nutrition Interventions in Pediatric Pancreatitis

Abstract

Objective: Despite the fact that pediatric pancreatitis is an uncommon disease, its prevalence has increased in recent years. Nevertheless, until 4 years ago, the lack of nutritional guidelines for pediatric pancreatitis was evident, with all recommendations being based on clinical practice guidelines (CPGs) for adults. The aim of the present study was to review and critically appraise guidelines for the medical nutrition therapy (MNT) of pediatric pancreatitis. Methods: A comprehensive search was performed in electronic databases (PubMed, Scopus, National Institute for Health and Care Excellence), the International Guidelines Network, BMJ best practice, and the Scottish Intercollegiate Guidelines Network to identify CPGs on the MNT of pediatric pancreatitis. The validated AGREE II tool was used for guidelines appraisal by a team of 3 independent multidisciplinary reviewers. Results: A total of 4 CPGs were retrieved with pediatric pancreatitis MNT information. Out of the 4 advising bodies in total, the joint society paper published by the ESPGHAN/NASPGHAN received the highest score in almost all domains, whereas the Belgian consensus obtained the lowest score in all domains but stakeholder involvement, and was not recommended by 2 out of 3 reviewers. Conclusions: Pediatric pancreatitis guidelines appear heterogenous in quality, rigour, and transparency. Our study points out existing gaps and biases in the CPGs, and delineates the need for improving the domains identified as being of low-quality.

A Systematic Review of Medical Nutrition Therapy Guidelines for Liver Cirrhosis: Do We Agree?

“…Several recent studies have suggested that nutrition guidelines are not adequately adhering to the standards for CPG development . This is why a collective initiative to ameliorate nutrition guideline quality has been proposed, using novel tools such as the NutriRECS .…”

JPEN Journal Club 60. AGREE II

“…I did identify 5 other similar systematic reviews that have been published by this group in the past 2 years, covering the topics of adults with severe burns, 4 celiac disease, 5 pediatric pancreatitis, 6 gestational diabetes, 7 and cirrhosis 8 . In all of these reviews, as was reported in this one as well, the guidelines were often found to be poorly developed and reported, as determined by the AGREE II criteria.…”