Nutrition in chronic pancreatitis  

作　　者：Henrik Hφjgaard Rasmussen φivind Irtun Sφren Schou Olesen Asbjφrn Mohr Drewes Mette Holst 

机构地区：[1]Centre for Nutrition and Bowel Disease (CET),Department of Gastroenterology and Hepatology,Aalborg University Hospital,Faculty of Health,Aalborg University,9000 Aalborg,Denmark [2]Department of Gastroenterologic Surgery,University Hospital North-Norway,9013 Troms ,Norway [3]Mech-Sense,Department of Gastroenterology and Hepatology,Aalborg University Hospital,9000 Aalborg,Denmark

出　　处：《World Journal of Gastroenterology》2013年第42期7267-7275,共9页世界胃肠病学杂志（英文版）

摘　　要：The pancreas is a major player in nutrient digestion.In chronic pancreatitis both exocrine and endocrine insufficiency may develop leading to malnutrition over time.Maldigestion is often a late complication of chronic pancreatic and depends on the severity of the underlying disease.The severity of malnutrition is correlated with two major factors:(1)malabsorption and depletion of nutrients(e.g.,alcoholism and pain)causes impaired nutritional status;and(2)increased metabolic activity due to the severity of the disease.Nutritional deficiencies negatively affect outcome if they are not treated.Nutritional assessment and the clinical severity of the disease are important for planning any nutritional intervention.Good nutritional practice includes screening to identify patients at risk,followed by a thoroughly nutritional assessment and nutrition plan for risk patients.Treatment should be multidisciplinary and the mainstay of treatment is abstinence from alcohol,pain treatment,dietary modifications and pancreatic enzyme supplementation.To achieve energy-end protein requirements,oral supplementation might be beneficial.Enteral nutrition may be used when patients do not have sufficient calorie intake as in pylero-duodenalstenosis,inflammation or prior to surgery and can be necessary if weight loss continues.Parenteral nutrition is very seldom used in patients with chronic pancreatitis and should only be used in case of GI-tract obstruction or as a supplement to enteral nutrition.The pancreas is a major player in nutrient digestion. In chronic pancreatitis both exocrine and endocrine insufficiency may develop leading to malnutrition over time. Maldigestion is often a late complication of chronic pancreatic and depends on the severity of the underlying disease. The severity of malnutrition is correlated with two major factors: (1) malabsorption and depletion of nutrients (e.g., alcoholism and pain) causes impaired nutritional status; and (2) increased metabolic activity due to the severity of the disease. Nutritional deficiencies negatively affect outcome if they are not treated. Nutritional assessment and the clinical severity of the disease are important for planning any nutritional intervention. Good nutritional practice includes screening to identify patients at risk, followed by a thoroughly nutritional assessment and nutrition plan for risk patients. Treatment should be multidisciplinary and the mainstay of treatment is abstinence from alcohol, pain treatment, dietary modifications and pancreatic enzyme supplementation. To achieve energy-end protein requirements, oral supplementation might be beneficial. Enteral nutrition may be used when patients do not have sufficient calorie intake as in pylero-duodenal-stenosis, inflammation or prior to surgery and can be necessary if weight loss continues. Parenteral nutrition is very seldom used in patients with chronic pancreatitis and should only be used in case of GI-tract obstruction or as a supplement to enteral nutrition.

关 键 词：Chronic PANCREATITIS MALNUTRITION NUTRITIONAL RISK MALABSORPTION NUTRITIONAL RISK screening Metabolism NUTRITIONAL assessment NUTRITION therapy 

分 类 号：R576[医药卫生—消化系统]