• Early EN is now standard of care in patients with acute pancreatitis
    • Recent research suggests improved outcomes compared with previous strategies of pancreatic rest with TPN
    • Guidance recommends commencing within 72 hours if intolerant of oral intake
  • Enteral nutrition in acute pancreatitis can be administered via either the nasojejunal or nasogastric route:
    • Many recommend early NJ feeding and supported by ESPEN guidance
    • Two trials have also found no difference in outcomes in patients fed gastrically versus jejunally
    • Nasogastric usually successful in 80% of patients
    • Nasojejunal feeding should be used if intra-abdominal pressures are >15mmHg
  • Parenteral nutrition can be administered in acute pancreatitis as second-line therapy if nasojejunal tube feeding is not tolerated (pain, ileus,  nausea)


(NICE & ESPEN Guidelines)

    Advantages of enteral nutrition include:

  • Cheaper
  • Avoids need for central line
  • Safer – associated with fewer complications
  • Better outcome overall
  • Maintains intestinal mucosal barrier
  • Prevents bacterial translocation