Nutritional Support in Pancreatic Diseases

Abstract

This review summarizes the main pancreatic diseases from a nutritional approach. Nutrition is a cornerstone of pancreatic disease and is sometimes undervalued. An early identification of malnutrition is the first step in maintaining an adequate nutritional status in acute pancreatitis, chronic pancreatitis and pancreatic cancer. Following a proper diet is a pillar in the treatment of pancreatic diseases and, often, nutritional counseling becomes essential. In addition, some patients will require oral nutritional supplements and fat-soluble vitamins to combat certain deficiencies. Other patients will require enteral nutrition by nasoenteric tube or total parenteral nutrition in order to maintain the requirements, depending on the pathology and its consequences. Pancreatic exocrine insufficiency, defined as a significant decrease in pancreatic enzymes or bicarbonate until the digestive function is impaired, is common in pancreatic diseases and is the main cause of malnutrition. Pancreatic enzymes therapy allows for the management of these patients. Nutrition can improve the nutritional status and quality of life of these patients and may even improve life expectancy in patients with pancreatic cancer. For this reason, nutrition must maintain the importance it deserves.

Nutritional Interventions during Chemotherapy for Pancreatic Cancer: A Systematic Review of Prospective Studies

“…Nutritional intervention strategy should include personalized nutritional counseling with a trained physician or dietitian specialized in oncological cures [ 30 ], with the evaluation of nutritional targets and intakes. According to the European Society of Nutrition and Metabolism (ESPEN) guidelines on nutrition in cancer patients, an energy intake of 25–30 kcal/kg/day and a protein intake of 1.0–1.5 g/kg/day should be guaranteed to all cancer patients [ 7 , 31 , 32 ].…”

CONUT score is associated with short-term prognosis in patients with severe acute pancreatitis: a propensity score matching cohort study

“…The CONUT score can also help clinicians provide better nutritional support to patients and reduce the incidence of death in SAP patients ( 32 , 33 ). For patients with severe acute pancreatitis, we should pay close attention to the nutritional status of patients, give nutritional support early, reduce the risk of malnutrition and improve the survival rate of patients ( 34 , 35 ). Patients with non-severe acute pancreatitis should also be concerned about their nutritional status to prevent progression to severe acute pancreatitis ( 36 ).…”

Fat malabsorption in pancreatic cancer: Pathophysiology and management

“…PN should be used (in contrast to EN) when the gastrointestinal tract is nonfunctional or when EN is not tolerated. PN is rarely used for patients with PDAC in clinical practice (aside from in the perioperative setting) 39,52,61 . In the hospitalized patient, supplemental PN should be considered when the patient is unable to meet >50% of nutrition needs through EN or during prehabilitation for those planning to undergo a surgical intervention for cancer treatment 62…”