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Practice Guideline
. 2020 Mar;39(3):612-631.
doi: 10.1016/j.clnu.2020.01.004. Epub 2020 Jan 22.

ESPEN guideline on clinical nutrition in acute and chronic pancreatitis

Marianna Arvanitakis  1 , Johann Ockenga  2 , Mihailo Bezmarevic  3 , Luca Gianotti  4 , Željko Krznarić  5 , Dileep N Lobo  6 , Christian Löser  7 , Christian Madl  8 , Remy Meier  9 , Mary Phillips  10 , Henrik Højgaard Rasmussen  11 , Jeanin E Van Hooft  12 , Stephan C Bischoff  13
Affiliations
Practice Guideline

ESPEN guideline on clinical nutrition in acute and chronic pancreatitis

Marianna Arvanitakis et al. Clin Nutr. 2020 Mar.

Abstract

Both acute and chronic pancreatitis are frequent diseases of the pancreas, which, despite being of benign nature, are related to a significant risk of malnutrition and may require nutritional support. Acute necrotizing pancreatitis is encountered in 20% of patients with acute pancreatitis, is associated with increased morbidity and mortality, and may require artificial nutrition by enteral or parenteral route, as well as additional endoscopic, radiological or surgical interventions. Chronic pancreatitis represents a chronic inflammation of the pancreatic gland with development of fibrosis. Abdominal pain leading to decreased oral intake, as well as exocrine and endocrine failure are frequent complications of the disease. All of the above represent risk factors related to malnutrition. Therefore, patients with chronic pancreatitis should be considered at risk, screened and supplemented accordingly. Moreover, osteoporosis and increased facture risk should be acknowledged in patients with chronic pancreatitis, and preventive measures should be considered.

Keywords: Acute pancreatitis; Chronic pancreatitis; Medical nutrition; Nutrition; Nutritional support; Pancreatic diseases.

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Conflict of interest statement

Conflict of interest The expert members of the working group were accredited by the ESPEN Guidelines Group, the ESPEN Education and Clinical Practice Committee, and the ESPEN executive. All expert members have declared their individual conflicts of interest according to the rules of the International Committee of Medical Journal Editors (ICMJE). If potential conflicts were indicated, they were reviewed by the ESPEN guideline officers and, in cases of doubts, by the ESPEN executive. None of the expert panel had to be excluded from the working group or from co-authorship because of serious conflicts. The conflict of interest forms are stored at the ESPEN guideline office and can be reviewed by ESPEN members with legitimate interest upon request to the ESPEN executive.

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