Gastric Feeding and "Gut Rousing" in Acute Pancreatitis

• Maxim S. Petrov, MD, MPH, PhD1

• <a id="aff-1" name="aff-1"/>1Department of Surgery, University of Auckland, Auckland, New Zealand

• Max Petrov, MD, MPH, PhD, Department of Surgery, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. Email: max.petrov{at}gmail.com

Abstract



The “pancreatic rest” concept is entrenched in the management of acute pancreatitis. As a result, “nonstimulatory” feeding has been widely advocated in patients with this disease, being parenteral nutrition 2–3 decades ago and jejunal tube feeding in the past decade. However, accumulating clinical evidence from the fields of acute pancreatitis and critical care medicine suggests that gastric feeding is as safe and effective as jejunal feeding in most patients. This has paved the way for a new conceptual framework called “gut rousing.” Acute pancreatitis management now requires consideration of gut function. Enteral nutrition is a gut-directed therapy, and avoiding stimulation of the pancreas in patients with acute pancreatitis need not overshadow the main goal of maintaining or restoring gut function.

• pancreatic diseases


• pancreatitis


• nutritional support


• enteral nutrition

• © 2014 American Society for Parenteral and Enteral Nutrition

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