Use of an elemental diet in the treatment of complicated pancreatitis

Voitk, Andrus J.; Brown, Ralph S.; Échavé, Vincent; McArdle, A. Hope; Gurd, Fraser N.; Thompson, Amanda L.

doi:10.1016/0002-9610(73)90031-7

Cited by 97 publications

(23 citation statements)

References 4 publications

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“…In a study by Foitzik et al [29,] the role of glutamine in an improvement of capillary blood flow in the bowel mucosa and a significant reduction in the prevalence of pancreatic infection in the rats with induced acute pancreatitis was found. Voitk et al [30] first demonstrated the beneficial effect of an elemental enteral diet in 6 patients with acute pancreatitis in 1973.…”

Section: Discussionmentioning

confidence: 99%

A Randomized Controlled Trial of Enteral versus Parenteral Feeding in Patients with Predicted Severe Acute Pancreatitis Shows a Significant Reduction in Mortality and in Infected Pancreatic Complications with Total Enteral Nutrition

2006

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Background: Infectious complications are the main cause of late death in patients with acute pancreatitis. Routine prophylactic antibiotic use following a severe attack has been proposed but remains controversial. On the other hand, nutritional support has recently yielded promising clinical results. The aim of study was to compare enteral vs. parenteral feeding for prevention of infectious complications in patients with predicted severe acute pancreatitis. Methods: We screened 466 consecutive patients with acute pancreatitis. A total of 70 patients with objectively graded severe acute pancreatitis were randomly allocated to receive either total enteral nutrition (TEN) or total parenteral nutrition (TPN), within 72 h of onset of symptoms. Baseline characteristics were well matched in the two groups. Results: The incidence of pancreatic infectious complications (infected pancreatic necrosis, pancreatic abscess) was significantly lower in the enterally fed group (7 vs. 16, p = 0.02). In the TEN group, 7 patients developed multiple organ failure whereas 17 parenterally fed patients developed multiple organ failure (p = 0.02). Overall mortality was 20% with two deaths in the TEN group and twelve in the TPN group (p < 0.01). Conclusion: Early TEN could be used as prophylactic therapy for infected pancreatic necrosis since it significantly decreased the incidence of pancreatic infectious complications as well as the frequency of multiple organ failure and mortality.

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Section: Discussionmentioning

confidence: 99%

A Randomized Controlled Trial of Enteral versus Parenteral Feeding in Patients with Predicted Severe Acute Pancreatitis Shows a Significant Reduction in Mortality and in Infected Pancreatic Complications with Total Enteral Nutrition

2006

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“…A few reports have shown that ED was useful in the management of pancreatitis since it is less simulating to the pancreas [5,17,18]. In particular, the Elental preparation used in the present study contains an extremely small amount of fat (0.17 g/100 kcal).…”

Section: Discussionmentioning

confidence: 90%

Medical Management of Chronic Pancreatitis: What Can Physicians Do?

Lee¹

2017

Korean J Pancreas Biliary Tract

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Background & Aims. Chronic pancreatitis (CP) is often associated with abdominal pain, which impairs quality of life. The aim of this prospective study was to clarify whether the use of a low-fat elemental diet (ED) is beneficial for managing pain in patients with CP. Methods. Seventeen CP patients with pain despite fat-restricted dietary and conventional medical treatments were enrolled in this prospective study. These patients received low-fat ED therapy in addition to restricting fat intake for 8 weeks. The change of pain severity was examined by interviewing the patient and status of analgesic use. Results. Mean serum levels of amylase and lipase at 8 weeks after the beginning of low-fat ED therapy decreased compared to those before the therapy. At 8 weeks, pain alleviation after low-fat ED therapy was reported in 15 out of 17 patients (88%). Of these 15 patients, 10 patients reported complete pain disappearance. One of 3 patients with severe or moderate pain requiring analgesic was relieved of analgesic use after low-fat ED therapy. Conclusion. Low-fat ED therapy is useful as means of pain control in CP. The therapy is recommended in outpatients with CP who present with pain despite conventional dietary and medical treatments.

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“…A 59-year-old man who had undergone total gastrectomy and total pancreatectomy for gastric cancer with pancreatic invasion 15 years previously takes 1,200 cal from regular foods and 900 cal of elementary diet (Elental®, Ajinomoto Co., Ltd., Tokyo) [4] by home enteral elemental hyperalimentation using a naso-jejunal tube. The patient receives 52.8 g/day of amino acid (composition is shown in Table 1 ) by enteral nutrition every day.…”

Section: Subject and Methodsmentioning

confidence: 99%

Effect of Glucagon on Plasma Amino Acid and Glucose Levels in a Patient Who Had Undergone Total Pancreatectomy.

Yagi

Shimizu

Izumi

et al. 1993

J. Clin. Biochem. Nutr.

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SummaryThe plasma glucose and amino acid levels of a patient who had undergone total gastrectomy and total pancreatectomy 15 years previously were examined under 4 conditions determined by the method of exogenous glucagon injection. Glucagon was not injected in the first period, and 1 mg of glucagon was injected twice a day in the second period. Twice a day 1 mg of zinc glucagon was injected in the third period, and 2 mg/day of glucagon by continuous subcutaneous glucagon infusion (CSGI) was given in the fourth period. The plasma pancreatic glucagon levels were within the normal range during CSGI. The effect of glucagon on plasma amino acid levels was greatest with CSGI. The effect became less in the order of zinc glucagon injection and twice-a-day injection of 1 mg of glucagon. Furthermore, afternoon hyperglycemia and nocturnal hypoglycemia were suppressed with CSGI. Urinary nitrogen excretion was increased with glucagon injection. However, excretion of 3-methylhistidine did not show any significant increase. From these results we consider that exogenous glucagon injection has significant effects on the metabolism of glucose and amino acids after total pancreatectomy. We also conclude that both continuous subcutaneous glucagon infusion and zinc glucagon are useful in the postoperative management of total pancreatectomy.

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Use of an elemental diet in the treatment of complicated pancreatitis

Cited by 97 publications

References 4 publications

A Randomized Controlled Trial of Enteral versus Parenteral Feeding in Patients with Predicted Severe Acute Pancreatitis Shows a Significant Reduction in Mortality and in Infected Pancreatic Complications with Total Enteral Nutrition

A Randomized Controlled Trial of Enteral versus Parenteral Feeding in Patients with Predicted Severe Acute Pancreatitis Shows a Significant Reduction in Mortality and in Infected Pancreatic Complications with Total Enteral Nutrition

Medical Management of Chronic Pancreatitis: What Can Physicians Do?

Effect of Glucagon on Plasma Amino Acid and Glucose Levels in a Patient Who Had Undergone Total Pancreatectomy.

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