Nutrition management and pancreatitis in children: new insights

Dike, Chinenye R.; Abu‐El‐Haija, Maisam

doi:10.1097/mco.0000000000000858

Cited by 4 publications

(2 citation statements)

References 23 publications

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“…Early enteral nutrition has been shown to improve outcomes, likely by preventing bacterial translocation, decreasing cytokine response, and reducing gastroparesis and ileus [20,25–27,28 ▪ ]. Furthermore, delayed nutrition may result in a catabolic state exacerbating an already hyperinflammatory condition.…”

Section: Managementmentioning

confidence: 99%

Acute pancreatitis in children: risk factors, management, and outcomes

Mehta

2023

Current Opinion in Pediatrics

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Purpose of review Pediatric acute pancreatitis is an infrequent but potentially serious condition in children. Most have mild cases with spontaneous resolution, but up to one-third of patients can have moderate or severe disease or progress to recurrent or chronic pancreatitis. Recent findings Significant advances have been made in the field of pediatric pancreatology with a recognition that pediatric acute pancreatitis can vary significantly from adult disease with different risk factors and outcomes. There is better understanding of appropriate management for pediatric pancreatitis as well as growing literature in complications of pancreatitis. Summary The most common risk factors for pediatric acute pancreatitis include biliary disease, drug/toxin and idiopathic. Management involves adequate fluid resuscitation, early enteral nutrition and appropriate pain control. Systemic and local complications, including SIRS, necrosis and fluid collections, can occur in up to one-third of patients and care is largely supportive with a careful step-up approach to fluid collections and necrosis.

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Section: Managementmentioning

confidence: 99%

Acute pancreatitis in children: risk factors, management, and outcomes

Mehta

2023

Current Opinion in Pediatrics

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“…Dike and Abu-El-Haija [1] discuss the role of diet in children's pancreatitis. Although most reviewed studies come from single centers, they indicate nutrition as a major contributor to the outcomes of acute pancreatitis in children and early enteral nutrition to be associated with improved outcomes.…”

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confidence: 99%

Editorial: Nutrition and the gastrointestinal tract

Correia

Gossum

2022

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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As editors of the gastrointestinal section of the journal, our goal is to select topics of utmost relevancy for clinical practice, supported by the most recent evidence and to invite experts in the field to author papers translating novel knowledge from the ''bench to patient practice''. However, this is not always feasible, since some areas are less well studied or lack good methodological papers. Nonetheless these topics deserve attention, and a review of recent literature may raise awareness and stimulate research. In this current 2022 issue, some invited authors have faced this challenge and presented us with compelling discussions.Dike and Abu-El-Haija [1] discuss the role of diet in children's pancreatitis. Although most reviewed studies come from single centers, they indicate nutrition as a major contributor to the outcomes of acute pancreatitis in children and early enteral nutrition to be associated with improved outcomes. Both malnutrition and obesity appear to worsen the severity of pancreatitis, and malnutrition is significantly associated with increased length of stay and costs of hospitalization. They call for more research to assess the effects of fat restriction versus a standard fat diet on both short-and long-term outcomes in pediatric pancreatitis. Of interest, the EFFORT (effect of dietary fat content on the recurrence of pancreatitis) trial will start including patients soon.The role of nutrition in adults' pancreatitis is covered by Arvanitakis et al. [2]. They discuss the role of obesity as a risk factor for severe acute pancreatitis and highlight early oral feeding to lead to shorter length of stay, fewer complications, and lower intolerance to oral feeding or severe disease, nutritional therapy should be started within 24-72 h, preferentially by enteral route, which appears superior to parenteral nutrition. Enteral nutrition can be administered through gastric or jejunal feeding, depending on digestive tolerance and the presence of dysmotility. The authors present that weight loss after discharge occurs frequently and could reflect pancreatic exocrine failure postacute pancreatitis. They also report novel research on gut microbiota that could open new therapeutic opportunities to prevent bacterial translocation and pancreatic necrosis infection.

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