Nutrition in Acute Pancreatitis: Have We Come Full Circle?

Current guidelines recommend early use of a nasoenteric tube with polymeric or semi-elemental formulas as the standard of care in patients with acute pancreatitis that is predicted to be severe (Am J Gastroenterol 2013; 108:1400). The early use of enteral nutrition has been considered important to stabilize the gut mucosal barrier and prevent bacterial translocation, thus reducing the risk for serious infections and death.

In the current randomized, controlled trial, investigators compared the rate of serious infection or death using different nutrition strategies in 208 patients with predicted severe acute pancreatitis at 19 Dutch hospitals. Patients were randomized to receive early placement of a nasoenteric tube and initiation of tube fee…